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Mansinho et al. J Cancer Metastasis Treat 2021;7:44 Journal of Cancer
DOI: 10.20517/2394-4722.2021.88
Metastasis and Treatment

Review Open Access

Management of bone metastases in renal cell
carcinoma: bone-targeted treatments, systemic

therapies, and radiotherapy

1,2
1,2
3
2,4
André Mansinho , Priscila Nejo , Tito Leitão , Sandra Casimiro , Luís Costa 1,2
1
Serviço de Oncologia Médica, Centro Hospitalar Universitário Lisboa Norte, Hospital de Santa Maria, Lisboa 1649-035, Portugal.
2
Luis Costa Laboratory, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisboa 1649-035,
Portugal.
3
Instituto Português de Oncologia Lisboa Francisco Gentil, Lisboa 1649-035, Portugal.
4
Urology Department, Centro Hospitalar Universitário Lisboa Norte, Hospital de Santa Maria, Lisboa 1649-035, Portugal.
Correspondence to: Prof. Luís Costa, Serviço de Oncologia Médica, Centro Hospitalar Universitário Lisboa Norte, Hospital de
Santa Maria, Av. Prof Egas Moniz, Lisboa 1649-035, Portugal. E-mail: luiscostaoncology@gmail.com
How to cite this article: Mansinho A, Nejo P, Leitão T, Casimiro S, Costa L. Management of bone metastases in renal cell
carcinoma: bone-targeted treatments, systemic therapies, and radiotherapy. J Cancer Metastasis Treat 2021;7:44.
https://dx.doi.org/10.20517/2394-4722.2021.88
Received: 2 Apr 2021 First Decision: 10 May 2021 Revised: 25 May 2021 Accepted: 2 Jun 2021 First online: 6 Jun 2021

Academic Editor: Hendrik Van Poppel Copy Editor: Yue-Yue Zhang Production Editor: Yue-Yue Zhang

Abstract
Metastatic renal cell carcinoma (mRCC) presents with bone metastases in around 20%-30% of patients enrolled
in the most recent first-line clinical trials. Emergence of several new agents in first line, in both monotherapy and
combination, has significantly improved patient outcomes. However, the activity of such agents on bone
metastases is unclear and management of these patients is complex, due to potential complications that can
significantly impair quality of life. This review addresses mRCC diagnosis and monitoring and summarizes the
current evidence on systemic therapy, ablative therapies such as stereotactic ablative radiotherapy and surgery,
and supportive therapy with bone-targeting agents for these patients, with the goal of improving their outcomes.

Keywords: Bone metastases, renal cell carcinoma, bone targeted treatments, radiotherapy, systemic therapy

INTRODUCTION
Renal cell carcinoma (RCC) is a heterogeneous disease, with clear cell RCC (ccRCC) representing about

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
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