Recent advances in localized RCC: A focus on VEGF and immuno-oncology therapies

Recent advances in advanced renal cell cancer (RCC) research have produced new drugs and therapies for patients with metastatic disease leading to higher response rates, improvements in progression-free survival, and longer overall survival. These advances have yet to be realized in patients with early-stage kidney cancer, and to date, no drug has been approved for the adjuvant treatment of localized kidney cancer. The current standard of care for localized high-risk kidney cancers is resection of the primary tumor. Here, we review the results of recently completed adjuvant vascular endothelial growth factor receptor 2 (VEGFR2) tyrosine kinase inhibitor (TKI) trials in RCC that have been reported, or are awaiting results. Further, we discuss the new immune checkpoint inhibitor adjuvant trials planned. There is hope that these trials may lead to new options and longer survival for patients with localized high-risk kidney cancer. •Surgery is the current standard of care for early-stage RCC.•Results of targeted therapy with sunitinib in 2 randomized trials in adjuvant RCC had differing results, which are discussed.•Design differences between multiple adjuvant RCC trials with VEGF-targeted agents are discussed.•New trials with immune checkpoint inhibitors in adjuvant RCC have been initiated.