Overview on the role of preoperative therapy in the management of kidney cancer

T Assi 1E El Rassy 2F Farhat 2J Kattan 2

Affiliations

1Department of Hematology-Oncology, Hotel Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon. tarekassi@gmail.com.

2Department of Hematology-Oncology, Hotel Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.

PMID: 31144210

DOI: 10.1007/s12094-019-02136-5

Abstract

The advent of molecular therapy through targeted kinase inhibitors (TKI) has revolutionized the management of renal cell carcinoma. Although surgical resection remains the cornerstone of any therapeutic plan, an increased risk of morbidity and mortality can be of concern in large and complex bulky tumors. Preoperative therapy with TKIs is hypothesized to facilitate resectability, reduce surgical morbidity and allow nephron-sparing surgery. Many concerns on the safety, efficacy and tolerability of these agents before surgery have halted the progress in this setting. In this paper, we will review the indications and safety of preoperative TKIs in RCC as well as the future approaches.

Keywords: Kidney cancer; Neoadjuvant; Preoperative; Presurgical; Renal cell carcinoma; Tyrosine kinase inhibitors.