Refractory Advanced Renal Cell Carcinoma

Renal cell carcinoma (RCC) is a cancer that affects the cells of the kidney. Renal cell carcinoma is the most common type of kidney cancer in adults, accounting for over 80% of all kidney cancers. When left untreated, the cancer can spread to other parts of the body. Advanced stage (or metastatic) RCC is the most problematic form of the disease, and is classified as either “refractory” or “non-refractory.”

What is Refractory Advanced Renal Cell Carcinoma?

Refractory renal cell carcinoma is a form of advanced renal cell carcinoma (RCC) in which the cancer has grown or spread beyond the local site of origin, and has become resistant to all available standard treatments. It is usually detected on routine scans or in lab test results. Refractory advanced RCC, which is also called “treatment-resistant” RCC, tends to respond poorly to systemic treatments and can be more difficult to control than other forms of advanced RCC. It is considered to be a “poor-prognosis” tumor type with a median survival rate of 13-26 months.

How is Refractory Advanced Renal Cell Carcinoma Treated?

Treatment strategies for refractory advanced RCC often include:

Targeted therapies such as inhibitors of the vascular endothelial growth factor (VEGF) or mTOR pathway.
Immunotherapy such as checkpoint inhibitors such as nivolumab or pembrolizumab.
Cytokine-based therapies such as interferon alpha or interleukin-2.
Chemotherapy.
Surgical resection and ablation.
Radiation.

In addition, patients with refractory advanced RCC may benefit from supportive treatments such as pain management and palliative care.

Conclusion

Refractory advanced renal cell carcinoma is an aggressive and difficult-to-treat form of advanced RCC. Despite the poor prognosis associated with the disease, treatment options are available that can help alleviate symptoms and improve quality of life.