The roaring 2020s: A new decade of systemic therapy for renal cell carcinoma

Arnav Srivastava, Sai K. Doppalapudi, Hiren V. Patel, Ramaprasad Srinivasan, Eric A. Singer

    Research output: Contribution to journalReview articlepeer-review

    6 Scopus citations


    Purpose of reviewThe genomic and immunologic profiling of renal cell carcinoma (RCC) has provided the impetus for advancements in systemic treatments using combination therapy - either with immune check point inhibitor (ICI)-+-ICI or with ICI-+-targeted therapy. This approach has been examined in several landmark trials, treating both clear cell (ccRCC) and nonclear cell (nccRCC) histologies. In this review, we highlight systemic therapy advancements made in this new decade, the 2020s.Recent findingsTargeting the programmed death receptor 1/PD-L1 pathway has created more tolerable and effective immunotherapy regimens, expanding the applications of ICIs. These new applications, paired with trial data, include ICI monotherapy in nccRCC and adjuvant pembrolizumab in resected, high-risk RCC. In addition, ICI-+-ICI and ICI-+-TKI combination therapy have demonstrated oncologic efficacy in advanced ccRCC and sarcomatoid RCC. Similar progress has been noted regarding new targeted therapies. Along the hypoxia inducible factor pathway, belzutifan has received FDA approval in von Hippel-Lindau-associated RCC. In addition, in papillary RCC, agents such as cabozantinib target the MET proto-oncogene pathway and have demonstrated impressive oncologic outcomes.SummaryThe 2020s utilize the molecular profiling of advanced RCC as a scaffold for recent trials in immunotherapy and targeted therapies. Going forward, emphasizing patient-reported outcomes and careful clinical trial construction remain critical to improve systemic therapy in RCC.

    Original languageEnglish (US)
    Pages (from-to)234-242
    Number of pages9
    JournalCurrent opinion in oncology
    Issue number3
    StatePublished - May 1 2022

    All Science Journal Classification (ASJC) codes

    • Oncology
    • Cancer Research


    • clear cell renal cell carcinoma
    • hypoxia inducible factor inhibitor
    • immune checkpoint inhibitors
    • nonclear cell renal cell carcinoma
    • systemic therapy


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