Most therapeutic approaches for renal cell carcinoma (RCC) help patients achieve remission or stable disease, and that’s about it. That may, however, be changing. The therapeutic landscape of RCC has improved over the last 10 years, and greater advances are expected, according to researchers in Italy who published an article suggesting that novel molecular targets for therapy may improve patient outcomes.1

The authors note that clinicians classify RCC based on tumor histology, and the disease is categorized as clear cell or non-clear cell. This dichotomy may become more complex, due to newly-found molecular biomarkers. It is hoped that the disease’s immunohistochemical features can be identified and targeted.

“The number of new drugs targeting key altered genes or pathways in all of the different types of RCC is exploding simultaneously with our ability to quickly determine the molecular fingerprint of any given tumor. With that knowledge and toolkit, we will be able to mix and match effective therapies more rapidly and more effectively than ever before,” said W. Kimryn Rathmell, MD, PhD, professor of medicine and director of the division of hematology/oncology at the Vanderbilt-Ingram Cancer Center in Nashville, Tennessee.

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Because of newer high-throughput studies, oncologists have a deep understanding of the genetic events that drive RCC. This includes molecular tools that can guide prognosis. “Several examples in clear cell RCC, including the mutation pattern of specific chromatin modifier genes, as well as gene expression tools, can enhance our ability to classify tumors, using integrated clinical and molecular features,” Dr Rathmell told Cancer Therapy Advisor.

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She added that precision medicine is changing the way clinical trials are designed. Non-clear cell RCC cases are treated with a greater appreciation for their biological differences, and are more often examined genomically for targeted therapy trials. These trials design treatment around the tumor genome itself.