Kidney Cancer, Version 3.2022, NCCN Clinical Practice Guidelines in Oncology

Abstract

The NCCN Guidelines for Kidney Cancer focus on the screening, diagnosis, staging, treatment, and management of renal cell carcinoma (RCC). Patients with relapsed or stage IV RCC typically undergo surgery and/or receive systemic therapy. Tumor histology and risk stratification of patients is important in therapy selection. The NCCN Guidelines for Kidney Cancer stratify treatment recommendations by histology; recommendations for first-line treatment of ccRCC are also stratified by risk group. To further guide management of advanced RCC, the NCCN Kidney Cancer Panel has categorized all systemic kidney cancer therapy regimens as “Preferred,” “Other Recommended Regimens,” or “Useful in Certain Circumstances.” This categorization provides guidance on treatment selection by considering the efficacy, safety, evidence, and other factors that play a role in treatment selection. These factors include pre-existing comorbidities, nature of the disease, and in some cases consideration of access to agents. This article summarizes surgical and systemic therapy recommendations for patients with relapsed or stage IV RCC.

A Cluster of Metabolic-Related Genes Serve as Potential Prognostic Biomarkers for Renal Cell Carcinoma

“…RCC, also known as renal adenocarcinoma, is a highly malignant tumor in the urinary system that accounts for 80–90% of malignant renal tumors. This disease has a high degree of heterogeneity, because it is associated with mild symptoms in its early stages and is thus usually diagnosed and treated once it has advanced ( Hsieh et al, 2017 ; Motzer et al, 2022 ). Kidney cancer is the third most common cancer of the genitourinary system, second only to prostate and bladder cancer, accounting for 2–3% of malignant tumors in adults ( MacLennan et al, 2012 ).…”

Integration of Tumor Microenvironment in Patient-Derived Organoid Models Help Define Precision Medicine of Renal Cell Carcinoma

“…Recent guidelines of RCC stress systemic treatment manipulating TME ( 51 ). As illustrated above, multiple targets TKIs inhibit angiogenesis by disturbing the signaling transduction of VEGFR or PDGFR, while ICBs target tumor-infiltrating CD8+ T cells and reverse the immune exhaustion state, both of which modulate TME of RCC instead of tumor epithelium.…”

Models of Renal Cell Carcinoma Used to Investigate Molecular Mechanisms and Develop New Therapeutics

“…Prognosis greatly depends on stage at diagnosis, with metastatic disease only demonstrating a 12% 5-year survival rate ( 8 , 10 ). Typically, standard of care therapy for RCC consists of surgery or ablative therapy for localized disease and systemic therapy for metastatic disease ( 11 – 13 ). Commonly targeted pathways in RCC include the hypoxia inducible factor (HIF) and mTOR pathways, and more recently immune checkpoint blockade ( 14 ).…”