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Systemic therapy for non-clear cell renal cell carcinomas: A systematic review
Journal article   Peer reviewed

Systemic therapy for non-clear cell renal cell carcinomas: A systematic review

Balqees Ara, Anum Babar, Durkho Atif, Bushra Ghafoor, Mustafa Shah, Syed Maaz Abdullah, Danish Safi and Amir Kamran
Journal of oncology pharmacy practice, Vol.31(1), pp.128-140
02/01/2025
PMID: 39529367

Abstract

Antineoplastic Agents - therapeutic use Antineoplastic Combined Chemotherapy Protocols - therapeutic use Carcinoma, Renal Cell - drug therapy Carcinoma, Renal Cell - pathology Humans Immune Checkpoint Inhibitors - therapeutic use Immunotherapy - methods Kidney Neoplasms - drug therapy Kidney Neoplasms - pathology Molecular Targeted Therapy Protein Kinase Inhibitors - administration & dosage Protein Kinase Inhibitors - pharmacology Protein Kinase Inhibitors - therapeutic use
Renal cell carcinoma (RCC) is the most common kidney cancer, with clear cell RCC being the predominant subtype. However, non-clear cell RCC constitutes a significant proportion of cases, presenting distinct challenges in treatment due to its varied histological subtypes. Despite recent advancements, the optimal therapeutic approach for non-clear cell RCC remains uncertain due to limited high-quality evidence. This systematic review aims to evaluate the efficacy of systemic therapies in nccRCC subgroups. A comprehensive literature search identified studies from 2010 to 2024, using PubMed and Clinicaltrials.gov databases focusing on clinical trials and treatment outcomes. Results highlight the evolving therapeutic landscape, with targeted agents and immunotherapy demonstrating promising anti-tumor effects. Notably, tyrosine kinase inhibitors (TKIs) such as sunitinib and mTOR inhibitors like temsirolimus have shown efficacy across different subtypes. Combination therapies, including immunotherapy-based regimens, have also shown favorable outcomes. immune checkpoint inhibitors such as nivolumab and pembrolizumab demonstrated encouraging antitumor activity. Furthermore, specific targeting of signaling pathways, such as the c-MET pathway, has demonstrated efficacy in certain PapillaryRCC. While combination therapies, including immunotherapies, have shown positive outcomes, immune checkpoint inhibitors like nivolumab and pembrolizumab have demonstrated encouraging antitumor activity. Additionally, targeting the c-MET pathway has proven effective in certain papillary RCC. Further research is warranted to establish optimal treatment strategies and improve outcomes for patients with non-clear cell RCC. Systemic therapy for non-clear cell RCC is complex and evolving. Further research is needed to delineate optimal treatment strategies for different histological subtypes and improve patient outcomes.

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