Learning objectives
Know the actual treatment and new therapies in mRCC.
Recognize the molecular basis behind novel anticancer agents in mRCC and how affects radiological response.
Describe typical and atypical radiologic response with the use of TAT in mRCC
Background
Renal cell carcinoma (RCC) account for 4% of all adult malignancies.
RCC is classificated in clear cell (80%),
papillary (10%),
chromophobe and other less common histologic types.
About 65% of patients have localized tumours (stage I,
II and III),
which are treated with partial or total nephrectomy.
On the other hand,
35% of patients who present with metastatic RCC (mRCC) or with relapse require systemic treatment.
The systemic first-line treatment in the past decade was Interleukin-2 (IL-2) and interferon alfa 2b (INFα2b),
however the complete...
Findings and procedure details
Molecular basis of RCC treatment
VHL is a tumour suppressor gene identified in familiar studies of VHL syndrome.
This group is identified in >90% of VHL mutations in spontaneous clear cell RCCs.
VHL is an E3 ubiquitin ligase that regulates a number of pro-angiogenic factors for degradation,
including vascular endothelial growth factor (VEGF).
Mutations that cause loss or silencing of VHL result in activation of these pro-angiogenic factors.
Identification of these mechanisms has led to the development of multiple VEGFR inhibitors that are now approved...
Conclusion
Recent advances in the therapy of renal carcinoma have extended the role of radiologist in patients with metastatic RCC.
Knowledge about TAT and recognize the patterns of response is essential for correct assessment in this patients.
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