ESMO E-Learning: Management of Non-Clear Cell Renal Cancer

In this E-Learning module, the author explains the classification of non-clear cell renal cancers, their incidence, prognosis, molecular alterations, especially those relevant from the therapeutic targeting aspect and current management; she also provides an overview of the results from the recent clinical trials, as well as an overview of currently ongoing clinical trials. 

The part of the module dedicated to treatment is divided into chapters about mTOR inhibitors and tyrosine kinase inhibitors, as well their comparison; MET inhibitors and the characterisation of advanced papillary renal cell carcinoma through comprehensive genomic profiling, as MET is a potential target across all papillary renal cell carcinomas, immune checkpoint inhibitors, as well as combinations of immune checkpoint inhibitors with tyrosine kinase inhibitors.

The author underlines the real need for biomarkers. Combinations of immune checkpoint inhibitors and tyrosine kinase inhibitors showed so far the best response rates​. MET inhibition in MET-driven tumours is a very logical approach.

By explaining why non-clear cell renal cell cancers are a group of heterogeneous diseases, the author argues that the oncology community should stop running trials that include all non-clear cell renal cancers and that instead the clinical trials by subtypes would be essential. The most recommended first-line treatment for these patients should be their inclusion into a clinical trial.