Choosing the best treatment for a patient with renal cell carcinoma involves a thorough assessment of the potential advantages and drawbacks of each targeted and immune therapy option based on the patient’s risk level and adjustment based on response to frontline treatment.
With new targeted and immune-based treatments coming out for renal cell carcinoma, predictive biomarkers are needed more than ever. The many different tumor entities of RCC, their genetic and mutational alterations and different clinical behaviors all contribute to a complex disease that requires personalized treatment.
More than half of patients diagnosed with renal cell carcinoma are at least 65 years old, and the median age at diagnosis is 64. Although increased life expectancies in general and prolonged survival times as a result of targeted therapies deserve optimism, elderly patients with renal cell carcinoma also bring unique clinical challenges. Beyond medical factors, social, psychological and financial elements also influence treatment practicalities and outcomes.
The introduction of targeted therapies in the management of metastatic renal cell carcinoma has markedly increased the treatment options available for these patients. These agents are now used in the first-line and second-line treatment settings, and beyond, to improve patient outcomes. Although many of these agents were approved on the basis of an improvement in progression-free survival, a recent analysis of a real-world patient population found that the use of targeted therapy has led to improved survival as well.
