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This review published in Clinical Genitourinary Cancer summarises the current treatments available for metastatic renal cell carcinoma (RCC), and the data from some of the most recent clinical trials, including CABOSUN, CheckMate 214, IMmotion151, and JAVELIN Renal 100. There is also a discussion about the use of biomarkers as predictors of outcomes for patients with metastatic RCC, for example PD-1, PD-L1, and mutations in genes such as PBRM1, KDM5C, VHL, NF1, TP53 and MET have been shown to influence survival in patients with RCC. The review discusses current understanding of the impact of the microbiome (gut microbes) on treatment, and concludes with a discussion about the use of circulating tumour DNA (ctDNA) to further inform treatment decisions for patients.
Treatments for metastatic RCC continue to evolve rapidly and various combinations of treatments are being tested to find the optimal regimen in different groups of patients. Biomarkers remain elusive, but as therapeutic strategies continue to progress with an increase in the number of combination treatments, biomarkers will be pivotal in tailoring therapies to metastatic RCC patients most likely to benefit.