The success of targeted therapies, including inhibitors of the vascular endothelial growth factor pathway or the mammalian target of rapamycin, in the treatment of metastatic renal cell carcinoma led to interest in testing their efficacy in the adjuvant setting. Results from the first trials are now available, with other studies due to report imminently. This review provides an overview of adjuvant targeted therapy in renal cell carcinoma, including interpretation of currently available conflicting data and future direction of research. We discuss the key differences between the completed targeted therapy adjuvant trials, and highlight the importance of accurately identifying patients who are likely to benefit from adjuvant treatment. We also consider reasons why blinded independent radiology review and treatment dose may prove critical for adjuvant treatment success. The implications of using disease-free survival as a surrogate end point for overall survival from the patient perspective and measurement of health benefit have recently been brought into focus and are discussed. Finally, we discuss how the ongoing adjuvant trials with targeted therapies and checkpoint inhibitors may improve our understanding and ability to prevent tumor recurrence after nephrectomy in the future.

中文翻译：

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肾细胞癌的辅助治疗：更高的复发风险是否会增加成功的机会？

在转移性肾细胞癌的治疗中，靶向疗法的成功，包括血管内皮生长因子途径的抑制剂或雷帕霉素的哺乳动物靶标，引起了对在佐剂环境中测试其功效的兴趣。现已获得第一批试验的结果，其他研究即将发布。这篇综述概述了肾细胞癌中靶向治疗的辅助方法，包括对目前可用的矛盾数据的解释和未来的研究方向。我们讨论了已完成的靶向治疗辅助试验之间的主要区别，并强调了准确识别可能从辅助治疗中受益的患者的重要性。我们还考虑了为什么对独立的放射学复习和治疗剂量盲法可能证明对辅助治疗成功至关重要的原因。从患者的角度来看，使用无病生存作为总体生存的替代终点，以及对健康的益处进行衡量，这已成为人们关注的焦点，并进行了讨论。最后，我们讨论了针对性疗法和检查点抑制剂的正在进行的佐剂试验如何在将来改善我们的理解和预防肾切除术后肿瘤复发的能力。