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Atmaja et al. J Cancer Metastasis Treat 2021;7:xx Journal of Cancer
DOI: 10.20517/2394-4722.2021.66
Metastasis and Treatment

Review Open Access

Individualized therapy for metastatic renal cell
carcinoma

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Bambang T. Atmaja , Izabelle Wood , Suyanto Suyanto , Paramvir Sawhney , Agnieszka Michael , Hardev
Pandha 1
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St Luke’s Cancer Centre, Royal Surrey County Hospital, Guildford GU2 7XX, UK.
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Department of Oncology, University College London Cancer Institute, London WC1E 6DD, UK.
Correspondence to: Dr. Bambang T. Atmaja and Dr. Izabelle Wood, St Luke’s Cancer Centre, Royal Surrey County Hospital,
Egerton Road, Guildford GU2 7XX, UK. E-mail: bambang.atmaja@nhs.net; izabelle.wood1@nhs.net
How to cite this article: Atmaja BT, Wood I, Suyanto S, Sawhney P, Michael A, Pandha H. Individualized therapy for metastatic
renal cell carcinoma. J Cancer Metastasis Treat 2021;7:xx. https://dx.doi.org/10.20517/2394-4722.2021.66
Received: 15 Mar 2021 First Decision: 8 May 2021 Revised: 19 May 2021 Accepted: 28 May 2021 First online: 2 Jun 2021
Academic Editor: Lucio Miele Copy Editor: Yue-Yue Zhang Production Editor: Yue-Yue Zhang

Abstract
Metastatic Renal Cell Carcinoma (mRCC) is a highly heterogeneous disease that is notoriously difficult to treat
successfully. However, the discovery of novel, targeted therapies over the last decade has revolutionized its
management. As the therapeutic options continue to evolve, developing a more individualized treatment strategy is
of paramount importance. The International mRCC Database Consortium (IMDC) is a prognostic model that is
commonly used in trials and clinical settings to risk stratify patients. This allows for optimal therapy selection on a
more individual basis. However, the distinct lack of validated predictive biomarkers in mRCC renders it difficult to
assess therapy response. An improved understanding of tumor biology and genetics has prompted a shift from
cytokine therapy to the use of vascular endothelial growth factor (VEGF) inhibitors, tyrosine kinase Inhibitors,
immune checkpoint inhibitors or combination strategies. Studies have identified some putative markers and
genetic mutations as potential predictors of therapy response. Early results are promising, and there are many
ongoing trials further assessing their suitability for clinical use. This review will evaluate the current treatment
landscape and molecular biology of mRCC, with a specific focus on the prognostic and predictive markers available
to guide treatment options and further improve patient outcomes.

Keywords: Metastatic renal cell carcinoma, IMDC, predictive biomarker, individualized therapy, immunotherapy,
VEGF, prognosis

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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