Abstract | PURPOSE: Thoughtful integration of surgical and medical approaches to metastatic renal cell carcinoma is paramount for maximizing disease control. Accomplishing this in the current era of targeted molecular therapies presents unique challenges and opportunities. MATERIALS AND METHODS: RESULTS: Cytoreductive nephrectomy provides an overall survival advantage in select patients with metastatic renal cell carcinoma who receive subsequent interferon-alpha. However, cytokine therapies are now being supplanted by targeted molecular approaches that block the effects of vascular endothelial growth factor and other molecular events. Although cytoreductive nephrectomy remains a standard of care, limited insight into the biological effects of nephrectomy on mechanisms such as immunoregulation and angiogenesis precludes definitive statements about how to integrate surgery and targeted agents. Ongoing investigation involving basic science and translational research is required to optimize the integration of these approaches. Adjuvant and neoadjuvant vascular endothelial growth factor targeted approaches to renal cell carcinoma are now also being explored and the unique side effects of these agents, including potential effects on wound healing and vascular integrity, require careful consideration. CONCLUSIONS:
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Authors | Brian I Rini, Steven C Campbell |
Journal | The Journal of urology
(J Urol)
Vol. 177
Issue 6
Pg. 1978-84
(Jun 2007)
ISSN: 0022-5347 [Print] United States |
PMID | 17509276
(Publication Type: Journal Article, Review, Systematic Review)
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Chemical References |
- Antineoplastic Agents
- Interferons
- Receptors, Vascular Endothelial Growth Factor
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Topics |
- Antineoplastic Agents
(therapeutic use)
- Carcinoma, Renal Cell
(secondary, therapy)
- Combined Modality Therapy
- Humans
- Interferons
(therapeutic use)
- Kidney Neoplasms
(pathology, therapy)
- Nephrectomy
- Receptors, Vascular Endothelial Growth Factor
(antagonists & inhibitors)
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