TY  - JOUR
AU  - Zhang, Xin-Wen
AU  - Jäger, Dirk
AU  - Zschäbitz, Stefanie
TI  - Management of Advanced Renal Cell Carcinoma.
JO  - Oncology research and treatment
VL  - 49
IS  - 1-2
SN  - 2296-5270
CY  - Basel
PB  - Karger
M1  - DKFZ-2026-00273
SP  - 26 - 34
PY  - 2026
N1  - #NCTZFB9#
AB  - Management of advanced renal cell carcinoma (RCC) has evolved significantly in the last years. Systemic treatment of clear cell RCC, the predominant subtype, is performed with immune checkpoint inhibitors (ICIs), anti-VEGF tyrosine kinase inhibitor (TKI), HIF2α inhibitors and mTOR inhibitors.The application of ICI in early disease has raised new challenges regarding subsequent therapy strategies and management of new toxicities of immunotherapy-based combination therapies. Systemic treatment for non-clear cell RCC is challenging due to the lack of robust clinical evidence for effective treatment regimens. Recent phase-2 data also indicate a benefit of ICI-combination therapies for non-clear cell RCC. For oligometastatic or oligoprogressive diseases, local therapy with cytoreductive nephrectomy, metastasectomy or stereotactic radiation can be considered. This review provides a comprehensive overview of current treatment strategies for advanced RCC, including systemic therapies for both clear cell and non-clear cell subtypes, management of treatment-associated toxicities, and the role of local therapies.Combination therapy for clear cell RCC is standard in first-line therapy and published data also support its use in non-clear cell carcinoma. Local therapies can be considered in selected patients. In subsequent treatment lines TKIs, mTOR inhibitors and the HIF2α inhibitor belzutifan are used.
KW  - Humans
KW  - Carcinoma, Renal Cell: therapy
KW  - Carcinoma, Renal Cell: pathology
KW  - Carcinoma, Renal Cell: mortality
KW  - Kidney Neoplasms: therapy
KW  - Kidney Neoplasms: pathology
KW  - Kidney Neoplasms: mortality
KW  - Combined Modality Therapy: methods
KW  - Immune Checkpoint Inhibitors: therapeutic use
KW  - Nephrectomy
KW  - Protein Kinase Inhibitors: therapeutic use
KW  - Molecular Targeted Therapy: methods
KW  - Antineoplastic Combined Chemotherapy Protocols: therapeutic use
KW  - Neoplasm Staging
KW  - Checkpoint inhibitor (Other)
KW  - HIF2α inhibitor (Other)
KW  - Metastasectomy (Other)
KW  - Renal cell carcinoma (Other)
KW  - Tyrosine kinase inhibitor (Other)
KW  - Immune Checkpoint Inhibitors (NLM Chemicals)
KW  - Protein Kinase Inhibitors (NLM Chemicals)
LB  - PUB:(DE-HGF)16
C6  - pmid:40494322
DO  - DOI:10.1159/000546879
UR  - https://inrepo02.dkfz.de/record/309639
ER  -