TY - JOUR AU - Haas, Naomi B. AU - Shevach, Jeffrey AU - Davis, Ian D. AU - Eisen, Tim AU - Gross-Gupil, Marine AU - Kapoor, Anil AU - Master, Viraj A. AU - Ryan, Christopher W. AU - Schimdinger, Manuela PY - 2022/11/15 Y2 - 2024/03/28 TI - Neoadjuvant and Adjuvant Therapy for Renal Cell Carcinoma JF - Société Internationale d'Urologie Journal JA - Soc Int Urol J VL - 3 IS - 6 SE - 2022 WUOF/SIU International Consultation on Urological Diseases DO - 10.48083/VSQG7437 UR - https://siuj.org/index.php/siuj/article/view/222 SP - 464-476 AB - Patients undergoing definitive surgery or ablative techniques for nonmetastatic kidney cancer have varying degreesof risk of recurrent disease post procedure. The ultimate goal of “adjuvant therapy” is to reduce the incidence ofrecurrent disease, and to cure more patients. We summarize the current state of perioperative therapy for kidneycancer and explore future directions to develop optimal adjuvant strategies. We define risk and risk of recurrencepost-definitive therapy, describe the controversies surrounding the trial landscape of adjuvant vascular endothelialgrowth factor receptor tyrosine kinase inhibitors and immune checkpoint inhibitors. We review data on neoadjuvanttherapy before advanced kidney cancer resection. Radiologic, ethnic, economic, and geographic considerationswith respect to adjuvant therapy are highlighted, as well as adjuvant therapy issues especially pertinent to patients,future directions in adjuvant trial design specifically targeted to biomarkers and patient selection, and sequencing oftreatment after adjuvant therapy in those patients with recurrence. ER -