Operative und systemische Therapie des Nierenzellkarzinoms

The treatment landscape of renal cell carcinoma has significantly evolved over the past 20 years. Localized and primary oligometastatic diseases can be curatively surgically treated with nephrectomy and, if needed, metastasectomy. Adjuvant immunotherapy is indicated following surgery in cases with a high risk of recurrence. For the systemic treatment of advanced renal cell carcinoma, several new combination therapies with immune checkpoint inhibitors and tyrosine kinase inhibitors have emerged in recent years, achieving objective response rates of up to 70% hence significantly improving the prognosis of advanced disease. Challenges of these new treatment options include the management of side effects as well as defining the treatment sequence in advanced treatment lines. This article provides an overview of current surgical and pharmaceutic treatment options and explains the selection and performance of various treatment strategies.