The Future of adjuvant therapy for renal cell carcinoma

Twenty to thirty percent of patients with stage I-III renal cell carcinoma will relapse within 5 years of surgery. Recent advances in our understanding of the molecular pathogenesis of renal cell carcinoma have led to several large randomized clinical trials investigating the role of molecularly targeted agents in the adjuvant setting. However, there are higher than expected drop-out rates due to the intolerability of side effects compared with treatment given in the metastatic setting. Additionally, significant challenges remain in the area of clinical trial design and the need to assess multiple potential therapies in a time- and cost-efficient manner, and to identify which patients are likely to benefit from adjuvant therapy.