L. Qu, Ding Wu, Haowei He, Xiaofeng Xu, Cheng Chen
{"title":"Immunotherapy for Renal Cell Carcinoma","authors":"L. Qu, Ding Wu, Haowei He, Xiaofeng Xu, Cheng Chen","doi":"10.5772/intechopen.77377","DOIUrl":"https://doi.org/10.5772/intechopen.77377","url":null,"abstract":"Despite the rapid development of therapeutic modalities for advanced or metastatic renal cell carcinoma (mRCC) over the past decade to include traditional immunotherapy, such as high-dose interleukin-2 and interferon-α, as well as a number of targeted anti - angiogenic therapies, mRCC continues to be associated with poor prognosis. Currently, immunotherapy has seen tremendous development in the form of immune checkpoint inhibition and vaccines at a dizzying pace, which are being studied in mRCC and are showing promise as important steps in the management of this disease. With so many drugs available to clinicians and patients, properly integrating immunotherapy espe cially immune checkpoint blockade (ICB) into the treatment paradigm is challenging. Emerging research with additional ICB agents and novel combination strategies is likely to further impact clinical decision-making. The further development of biomarkers for predicting a response is required to achieve optimal efficacy with these therapeutic interventions. This chapter summarizes the current landscape of standard and emerging immune therapeutics and other modalities for mRCC.","PeriodicalId":198525,"journal":{"name":"Evolving Trends in Kidney Cancer","volume":"95 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126473183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Genetic Susceptibility to Kidney Cancer","authors":"M. Kankuri-Tammilehto","doi":"10.5772/intechopen.91933","DOIUrl":"https://doi.org/10.5772/intechopen.91933","url":null,"abstract":"According to the latest knowledge, hereditary kidney cancers may account for 5 – 8% of all kidney cancers, and it may be more common than previously thought. Hereditary RCC is often characterized by an early age of onset (approximately 45 years), typical histological pattern, and frequently the bilaterality and multicentricity of the primary tumor. Wilms ’ tumor (nephroblastoma) is the most common kidney tumor of childhood. More than 15 syndromes with inherited susceptibility to kidney cancer are known, and there are over 25 known genes associated with them. Most of these are dominantly inherited in which the offspring of the proband has a 50% chance of inheriting a gene mutation with susceptibility to kidney cancer. The aggressiveness of hereditary RCCs and recommended surgery varies depending on the syndrome and mutation type. Also, systemic therapy may be optional. Multigene next generation sequencing (NGS) panel technology allows genes of interest to be studied quickly and cost-effectively. Sequencing investigations have improved the accuracy of hereditary cancer diagnoses. Diagnostic utility has been hugely increased by multigene NGS panels. It is important to identify hereditary cancer susceptibility, because the risk of cancer in the mutation carriers can be reduced. In this review article, the latest literature on syndromes subjecting to hereditary kidney cancer and recommended follow-up is summarized.","PeriodicalId":198525,"journal":{"name":"Evolving Trends in Kidney Cancer","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126097164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Augmented Reality in Kidney Cancer","authors":"K. Mudgal, Neelanjan Das","doi":"10.5772/INTECHOPEN.81890","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.81890","url":null,"abstract":"Augmented reality(AR) is the concept of a digitally created perception that enhances components of the real-world to allow better engagement with it. Within healthcare, there has been a recent expansion of AR solutions, especially in the field of surgery. Traditional renal cancer surgery has been largely replaced by minimally invasive laparoscopic (or robotic) partial nephrectomies. This has meant loss of certain intra-operative experiences such as haptic feedback and AR can aid this replacement with enhanced visual and patient-specific feedback. The kidney is a dynamic organ and current AR development has revolved around specific surgical stages such as safe arterial clamping and perfecting tumour margins. This chapter discusses the current state of AR technol - ogy in these areas with key attention to the aspects of image registration, organ track ing, tissue deformation and live imaging. The chapter then discusses limitations of AR, such as intentional blindness and depth perception and provides potential future ideas and solutions. These include inventions such as AR headsets and 3D-printed renal mod - els (with the possibility of remote surgical intervention). AR provides a very positive outcome for the future of truly minimally invasive renal surgery. However, current AR needs validation, cost evaluation and thorough planning before being safely integrated into everyday surgical practice.","PeriodicalId":198525,"journal":{"name":"Evolving Trends in Kidney Cancer","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133729044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Current Role of Adjuvant Therapy in High Risk for Recurrence Resected Kidney Cancer","authors":"Fadil Hassan, S. Lambe, K. Sharma, A. Kapoor","doi":"10.5772/INTECHOPEN.78684","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.78684","url":null,"abstract":"Renal cell carcinoma accounts for about 2% of all adult malignancies. More than 300,000 individuals are affected each year. Unfortunately, around 30% of cases are discovered in advanced stages. Surgical resection remains the mainstay of treatment for localized disease and relapses can reach up to 40% in some cases. The effective treatment of metastatic RCC with systemic targeted therapy gives a strong rationale for its use as adjuvant treatment in high-risk patients. This chapter reviews different modalities that have been used as an adjuvant therapy for nonmetastatic renal cancer. Clinical trials using targeted therapy are discussed in detail, as they are becoming options for treat ment in high-risk patients. While the current set of completed adjuvant clinical trials have provided conflicting results, there are additional large-scale trials that are still in progress. Future directions include—incorporating a genetic recurrence score to evalu- ate risk of relapse in patients, developing an adequate and an objective standardized adjuvant trial design, identifying novel biomarkers, and evaluating novel drug targets. Based upon current clinical trial evidence, motivated high-risk patients should have a discussion with the urology oncology team regarding the benefits of adjuvant TKI sunitinib or consider enrollment in current ongoing immuno-oncology (IO) adjuvant clinical trials. incorporating a genetic recurrence score to evaluate risk of relapse in patients, developing an adequate and an objectively standardized adjuvant trial design, identifying novel biomarkers and evaluating novel drug targets.","PeriodicalId":198525,"journal":{"name":"Evolving Trends in Kidney Cancer","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131311896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Ciobanu, A. Szora, A. Badea, M. Suciu, R. Badea
{"title":"Harmonic Contrast-Enhanced Ultrasound (CEUS) of Kidney Tumors","authors":"L. Ciobanu, A. Szora, A. Badea, M. Suciu, R. Badea","doi":"10.5772/INTECHOPEN.77376","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.77376","url":null,"abstract":"Nowadays, kidney tumor diagnosis benefits from large and highly accurate imagistic methods. A new imagistic method is contrast-enhanced ultrasound (CEUS) that accurately depicts the circulatory pattern of tumors. In kidney pathology, any mass or even capsular deformation depicted by B mode ultrasound represents an indication for CEUS. The kidney is completely and uniformly vascularized. In cystic tumors, there is a lack of contrast loading. In “impure” cystic masses (Bosnian 3 and 4), CEUS reveals vascularized septa and walls. In malignant tumors, accelerated and heterogeneous loading of contrast agent is observed in arterial phase followed by early, inhomogeneous washout of the contrast agent compared to normal renal parenchyma. In the abscesses, the appearance is the early loading of the walls associated with moderate hyperemia of the normal circulatory bed. This chapter details the CEUS in kidney tumor pathology, emphasizing the accurate information for the circulatory pattern of renal masses. It requires correlations with clinical data and information provided by other imaging explorations to make a final diagnosis.","PeriodicalId":198525,"journal":{"name":"Evolving Trends in Kidney Cancer","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128090971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Target Therapy for Kidney Cancer","authors":"Yang Wang, Lingxiang Liu","doi":"10.5772/INTECHOPEN.73386","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.73386","url":null,"abstract":"Objectives : Renal cell carcinoma (RCC) is considered a chemotherapy-resistant tumor; the landscape of metastatic RCC (mRCC) is rapidly changing due to the development of target therapy. By now, ten novel agents have dramatically improved the prognosis of mRCC. The purpose of this chapter is to provide an updated overview of the clinical data, which support the use of these agents. Methods : We conducted a systematic review using PubMed and ClinicalTrials.gov about target therapy in RCC according to the existing guidelines, made analysis of the clinic trials, and discussed their mechanism, impact on quality of life (QoL), and patient selec- tion algorithms. Results : A total of 11 completed phase III trials were included in our research data. Agreement was correlated with the availability of data in seven trials, contributing to the category 1 option of first-line therapy for patients with mRCC. Three completed phase III trials contributed for the subsequent therapy as the evidence. Conclusions : Target therapy shows promise in clinical practice. Guidelines and algo- rithms should be revised and adapted to the new target drugs. However, more research is needed in parallel to discover biomarkers that enable the prediction of a treatment response and therefore lead to better patient selection. into two cabozantinib at a of 60 everolimus at 10 mg Median PFS and ORR were superior in the experimental arm: 7.4 vs. 3.8 months (HR 0.58; 95% CI 0.45 – 0.75), and ORR 21 vs. 5%, respectively. A planned interim analysis showed that OS was improved in the cabozantinib arm (HR 0.67; 95% CI 0.51 0.89; P = 0.005). Grade 3 – 4 AEs were reported in 74% of cabozantinib arm and 65% of the everolimus arm.","PeriodicalId":198525,"journal":{"name":"Evolving Trends in Kidney Cancer","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114324382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cheng Peng, L. Gu, Luojia Yang, Baojun Wang, Qingbo Huang, Dan Shen, Songliang Du, Xu Zhang, Xin Ma
{"title":"Surgical Strategy for the Management of Renal Cell Carcinoma with Inferior Vena Cava Tumor Thrombus","authors":"Cheng Peng, L. Gu, Luojia Yang, Baojun Wang, Qingbo Huang, Dan Shen, Songliang Du, Xu Zhang, Xin Ma","doi":"10.5772/INTECHOPEN.73294","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.73294","url":null,"abstract":"Additional information is available at the end of the chapter Abstract The hallmark of renal cell carcinoma is its biological characteristic of invading the renal vein and/or inferior vena cava (IVC), which occurs in 4–10% of patients. Radical nephrectomy (RN) with tumor thrombectomy is the standard approach for treating such chal- lenging cases. Except tumor thrombus height, several factors can determine the surgical strategy, including the effect of targeted molecular therapy (TMT), invasion of the IVC wall, venous occlusion, establishment of collateral circulation, IVC thromboembolism, and primary tumor location. The surgical strategy for patients with retrohepatic vena cava tumor thrombi depends on the upper extent of the tumor thrombus. In addition, the first porta hepatis and hepatic veins are important anatomical boundaries. Based on previous studies, the effect of pre-surgical TMT is limited. The safety of IVC venography, an imaging modality that can observe congestion of the tumor thrombus and show the collateral circulation, has considerably improved. IVC interruption plays an important role in tumor thrombectomy for patients with invasion of the venous walls, complete occlusion of the vena cava, and the presence of distal thrombus. A series of retrospective and prospective studies are needed to be conducted, which will provide our clinical work with more powerful reference and basis.","PeriodicalId":198525,"journal":{"name":"Evolving Trends in Kidney Cancer","volume":"112 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124135800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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