Papillary Renal Cell Carcinoma: A Review of Prospective Clinical Trials.
Benjamin L MaughanDeepika SirohiPublished in: Current treatment options in oncology (2023)
PRCC is a unique histologic entity compared to other forms of renal cell carcinoma, harboring distinct molecular drivers. The WHO 2022 classification is further emphasizing the molecular biology by making molecular classifications of PRCC subclassifications and discontinuing the morphologic type 1 and type 2 classification system. We agree with this functional classification system and encourage all future clinical trials to only include patients with similar diagnosis instead of conducting basket trials (including all nccRCC together) which limits the scientific value of those conclusions. Based on recent disease-specific clinical trial (S1500, PAPMET), the current standard of care for patients with treatment naïve PRCC is cabozantinib. Prospective clinical trials clearly establish that immune checkpoint inhibitor therapy has meaningful activity in PRCC. The data to date include only single-arm clinical trials of combination immune therapy. Despite the positive and encouraging results, we need validation through randomized studies because of the overestimation of effect size seen in single-arm trials. These randomized trials are currently underway and enrolling. We strongly encourage all physicians to support these studies and enroll patients with PRCC to these trials in order to continue improving the standard of care.
Keyphrases
- clinical trial
- renal cell carcinoma
- phase ii
- double blind
- open label
- phase iii
- healthcare
- placebo controlled
- study protocol
- primary care
- machine learning
- quality improvement
- single molecule
- case control
- deep learning
- pain management
- current status
- affordable care act
- stem cells
- replacement therapy
- cell therapy
- mesenchymal stem cells