PMID- 27034725
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160401
LR  - 20220321
IS  - 1756-2872 (Print)
IS  - 1756-2880 (Electronic)
IS  - 1756-2872 (Linking)
VI  - 8
IP  - 2
DP  - 2016 Apr
TI  - The role of neoadjuvant therapy in the management of locally advanced renal cell 
      carcinoma.
PG  - 130-41
LID - 10.1177/1756287215612962 [doi]
AB  - In the past decade, the armamentarium of targeted therapy agents for the 
      treatment of metastatic renal cell carcinoma (RCC) has significantly increased. 
      Improvements in response rates and survival, with more manageable side effects 
      compared with interleukin 2/interferon immunotherapy, have been reported with the 
      use of targeted therapy agents, including vascular endothelial growth factor 
      (VEGF) receptor tyrosine kinase inhibitors (sunitinib, sorafenib, pazopanib, 
      axitinib), mammalian target of rapamycin (mTOR) inhibitors (everolimus and 
      temsirolimus) and VEGF receptor antibodies (bevacizumab). Current guidelines 
      reflect these new therapeutic approaches with treatments based on risk category, 
      histology and line of therapy in the metastatic setting. However, while radical 
      nephrectomy remains the standard of care for locally advanced RCC, the migration 
      and use of these agents from salvage to the neoadjuvant setting for large 
      unresectable masses, high-level venous tumor thrombus involvement, and patients 
      with imperative indications for nephron sparing has been increasingly described 
      in the literature. Several trials have recently been published and some are still 
      recruiting patients in the neoadjuvant setting. While the results of these trials 
      will inform and guide the use of these agents in the neoadjuvant setting, there 
      still remains a considerable lack of consensus in the literature regarding the 
      effectiveness, safety and clinical utility of neoadjuvant therapy. The goal of 
      this review is to shed light on the current body of evidence with regards to the 
      use of neoadjuvant treatments in the setting of locally advanced RCC.
FAU - Borregales, Leonardo D
AU  - Borregales LD
AD  - Department of Urology, University of Texas MD Anderson Cancer Center, Houston, 
      TX, USA.
FAU - Adibi, Mehrad
AU  - Adibi M
AD  - Department of Urology, University of Texas MD Anderson Cancer Center, Houston, 
      TX, USA.
FAU - Thomas, Arun Z
AU  - Thomas AZ
AD  - Department of Urology, University of Texas MD Anderson Cancer Center, Houston, 
      TX, USA.
FAU - Wood, Christopher G
AU  - Wood CG
AD  - Department of Urology, University of Texas MD Anderson Cancer Center, Houston, 
      TX, USA.
FAU - Karam, Jose A
AU  - Karam JA
AD  - Department of Urology, University of Texas MD Anderson Cancer Center, 1515 
      Holcombe Blvd, Unit 1373, Houston, TX 77030, USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20151120
PL  - England
TA  - Ther Adv Urol
JT  - Therapeutic advances in urology
JID - 101487328
PMC - PMC4772353
OTO - NOTNLM
OT  - locally advanced
OT  - neoadjuvant
OT  - nephrectomy
OT  - preoperative
OT  - presurgical
OT  - renal cell carcinoma
OT  - targeted therapy
COIS- Conflict of interest statement: Jose A. Karam has served as a one-time consultant 
      to Pfizer in 2013. Christopher G. Wood has received research funding from Pfizer 
      and served as a consultant and on its advisory board.
EDAT- 2016/04/02 06:00
MHDA- 2016/04/02 06:01
PMCR- 2016/04/01
CRDT- 2016/04/02 06:00
PHST- 2016/04/02 06:00 [entrez]
PHST- 2016/04/02 06:00 [pubmed]
PHST- 2016/04/02 06:01 [medline]
PHST- 2016/04/01 00:00 [pmc-release]
AID - 10.1177_1756287215612962 [pii]
AID - 10.1177/1756287215612962 [doi]
PST - ppublish
SO  - Ther Adv Urol. 2016 Apr;8(2):130-41. doi: 10.1177/1756287215612962. Epub 2015 Nov 
      20.