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Management of Non-clear Cell Renal Cell Carcinoma

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Renal Cancer

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Abstract

Renal cell carcinoma comprises a large, heterogeneous group of tumors. Although clear cell renal cancer is the most common subtype, 20–25 % of renal malignancies are of variant histology. Papillary renal cell carcinoma represents the most common non-clear cell histology, with unclassified, chromophobe, collecting duct, and renal medullary carcinoma making up the majority of the remainder. With the exception of collecting duct and renal medullary carcinoma, non-clear cell renal cancers tend to be resistant to chemotherapy. All non-clear cell subtypes are resistant to immunotherapy. Their limited representation in large phase III randomized trials lends to uncertainty regarding the benefit of targeted therapy in this group.

Although anti-vascular endothelial growth factor (VEGF) agents and mammalian target of rapamycin (mTOR) inhibitors have made a large impact in the management of advanced clear cell renal cell carcinoma, their use in non-clear cell histologies is controversial. As we learn more about these tumor types, new subtypes of non-clear cell kidney cancer and new genetic abnormalities are being discovered. Hopefully, this improved understanding will lead to better treatments in the future for our patients.

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Authors and Affiliations

  1. Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Henry J. Conter

  2. Department of Urology, Division of Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Jose A. Karam

  3. Department of Genitourinary Medical Oncology, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, 1155 Hermann Pressler Dr, Houston, TX, 77030, USA

    Nizar M. Tannir

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  1. Henry J. Conter
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  2. Jose A. Karam
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  3. Nizar M. Tannir
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Correspondence to Nizar M. Tannir .

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  1. , Institute of Urology, Lahey Clinic, 41 Mall Road, Burlington, 01805, Massachusetts, USA

    John A Libertino

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Conter, H.J., Karam, J.A., Tannir, N.M. (2013). Management of Non-clear Cell Renal Cell Carcinoma. In: Libertino, J. (eds) Renal Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7236-0_23

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