The promising role of radiotherapy in the treatment of advanced or metastatic renal cell carcinoma: a narrative review

Wei, Qinghong; He, Huan; Lv, Long; Xu, Xiaoying; Sun, Wei

doi:10.21037/tau-20-1466

Cited by 12 publications

(8 citation statements)

References 67 publications

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“…A toll-like receptor 9 agonist was also successfully tested in metastatic lung adenocarcinoma in mice in order to turn off the immunosuppressive effects of high radiation doses (12 Gy × 3 fractions) so as to clearly prevail tumoricidal ones [97]. High radiation doses combined with immunotherapies are able to break through the wall of radioresistance of some tumors, such as renal cell carcinoma, notoriously refractory to conventionally fractionated radiotherapy, and also improve systemic control by producing abscopal effects [98]. Evolving tumor-host interactions in patients treated with high dose radiotherapy and anti-PD1 immunotherapy could be detected by circulating biomarkers, on the basis of which it might be possible to classify patients as responders or non-responders in order to promptly switch the latter to other treatments early [99].…”

Section: High Dose Per Fraction Radiotherapy and Immunotherapy: The Most Recent Evidence For A Successful Cooperationmentioning

confidence: 99%

Lattice or Oxygen-Guided Radiotherapy: What If They Converge? Possible Future Directions in the Era of Immunotherapy

Ferini¹,

Valenti²,

Tripoli³

et al. 2021

Cancers

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Palliative radiotherapy has a great role in the treatment of large tumor masses. However, treating a bulky disease could be difficult, especially in critical anatomical areas. In daily clinical practice, short course hypofractionated radiotherapy is delivered in order to control the symptomatic disease. Radiation fields generally encompass the entire tumor mass, which is homogeneously irradiated. Recent technological advances enable delivering a higher radiation dose in small areas within a large mass. This goal, previously achieved thanks to the GRID approach, is now achievable using the newest concept of LATTICE radiotherapy (LT-RT). This kind of treatment allows exploiting various radiation effects, such as bystander and abscopal effects. These events may be enhanced by the concomitant use of immunotherapy, with the latter being ever more successfully delivered in cancer patients. Moreover, a critical issue in the treatment of large masses is the inhomogeneous intratumoral distribution of well-oxygenated and hypo-oxygenated areas. It is well known that hypoxic areas are more resistant to the killing effect of radiation, hence the need to target them with higher aggressive doses. This concept introduces the “oxygen-guided radiation therapy” (OGRT), which means looking for suitable hypoxic markers to implement in PET/CT and Magnetic Resonance Imaging. Future treatment strategies are likely to involve combinations of LT-RT, OGRT, and immunotherapy. In this paper, we review the radiobiological rationale behind a potential benefit of LT-RT and OGRT, and we summarize the results reported in the few clinical trials published so far regarding these issues. Lastly, we suggest what future perspectives may emerge by combining immunotherapy with LT-RT/OGRT.

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Section: High Dose Per Fraction Radiotherapy and Immunotherapy: The Most Recent Evidence For A Successful Cooperationmentioning

confidence: 99%

Lattice or Oxygen-Guided Radiotherapy: What If They Converge? Possible Future Directions in the Era of Immunotherapy

Ferini¹,

Valenti²,

Tripoli³

et al. 2021

Cancers

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“…1 About 50% of metastatic BC presents with less than three metastatic lesions. 3 Clinical evidence of longer overall survival (OS) in patients with a limited metastatic burden 4,5 and advances in local technique modalities, such as surgery and stereotactic ablative radiotherapy (SABR), as well as in systemic therapy (Figure 1), has generated interest in the multimodal approach Oligometastatic breast cancer and metastasis-directed treatment: an aggressive multimodal approach to reach the cure for oligometastatic BC (OMBC) aimed at longterm complete remission at the cost of added toxicity. 6 However, the data supporting this treatment strategy refer mostly to retrospective or prospective non-randomized studies, with a heterogeneous definition of oligometastatic disease, the inclusion of various tumor histologies, and a lack of BC subtype stratification.…”

Section: Introductionmentioning

confidence: 99%

Oligometastatic breast cancer and metastasis-directed treatment: an aggressive multimodal approach to reach the cure

et al. 2023

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Metastatic breast cancer (BC) is considered an incurable disease and is usually treated with palliative intent. However, about 50% of metastatic BCs present with only a few metastatic lesions and are characterized by longer overall survival. These patients, defined as oligometastatic, could benefit from a multimodal approach, which combines systemic therapy with metastasis-directed treatment (stereotactic ablative therapy or surgery). The current definition of oligometastatic seems incomplete since it is based only on imaging findings and does not include biological features, and the majority of relevant data supporting this strategy comes from retrospective or non-randomized studies. However, the chance of reaching long-term complete remission or even a cure has led to the development of randomized trials investigating the impact of combined treatment in oligometastatic BC (OMBC). The SABR-COMET trial, the first randomized study to include BC patients, showed promising results from a combination of stereotactic ablative radiotherapy and systemic therapy. Considering the randomized trial’s results, multidisciplinary teams should be set up to select OMBC patients who could achieve long-term survival with aggressive multimodal treatment.

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“…Clear cell RCC (ccRCC) is the most common and most malignant histological type of RCC, accounting for 70-85% of the incidence of RCC (3). At present, radical nephrectomy is the main treatment modality for RCC in clinical practice, but there is still a lack of proven methods for treating patients with advanced renal cancer and those with recurrence and metastasis after renal cancer surgery (4,5). Due to the lack of reliable clinical diagnostic biomarkers and typical early clinical symptoms, approximately more than 25% of RCC patients are already metastatic at the time of diagnosis, which makes simple surgical treatment difficult and shortens the survival time of patients (6).…”

Section: Introductionmentioning

confidence: 99%

TLN2 functions as a tumor suppressor in clear cell renal cell carcinoma via inactivation of the Wnt/β-catenin signaling pathway

Cai¹,

Huang²,

Zhou³

et al. 2022

Transl Androl Urol

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Background: Clear cell renal cell carcinoma (ccRCC) is one of the most prevalent malignancies worldwide, but there is lack of reliable clinical diagnostic biomarkers. We explored the clinical value and functions of Talin 2 (TLN2) in the progression of ccRCC.Methods: A bioinformatic analysis was performed to determine the clinical value of TLN2 in ccRCC.TLN2 expression was evaluated by immunohistochemistry (IHC), real-time quantitative polymerase chain reaction (RT-qPCR) and western blot in ccRCC tissues and cells. The functions of TLN2 in ccRCC were investigated by both in vivo and in vitro studies. The functions of TLN2 in ccRCC cell proliferation was determined by CCK-8 assays and colony formation assays. Transwell assays and wound healing assays were performed to detect the effects of TLN2 on ccRCC cell invasion and migration abilities. Apoptosis assay and cell cycle analysis were used to determine the influence of TLN2 on ccRCC cell apoptosis and cell cycle.Results: TLN2 was downregulated in ccRCC tissues and cells. Clinically, TLN2 was confirmed to be an independent factor for ccRCC patient prognosis. Results of colony formation and CCK-8 assays showed that TLN2 overexpression inhibited ccRCC cell growth. Moreover, wound healing assays and transwell assays indicated that TLN2 overexpression inhibited ccRCC cell invasion and migration. In vivo assays also indicated that TLN2 played an important role in ccRCC cell growth and metastasis. TLN2 also inhibited cell cycle progression and promoted apoptosis of ccRCC cells. Mechanistically, TLN2 was confirmed to exert anti-ccRCC functions through Wnt/β-catenin signaling.Conclusions: TLN2 served as a tumor regulator of ccRCC via Wnt/β catenin signaling, suggesting that it could be a promising therapeutic and prognostic biomarker for ccRCC.

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The promising role of radiotherapy in the treatment of advanced or metastatic renal cell carcinoma: a narrative review

Cited by 12 publications

References 67 publications

Lattice or Oxygen-Guided Radiotherapy: What If They Converge? Possible Future Directions in the Era of Immunotherapy

Lattice or Oxygen-Guided Radiotherapy: What If They Converge? Possible Future Directions in the Era of Immunotherapy

Oligometastatic breast cancer and metastasis-directed treatment: an aggressive multimodal approach to reach the cure

TLN2 functions as a tumor suppressor in clear cell renal cell carcinoma via inactivation of the Wnt/β-catenin signaling pathway

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