A multidisciplinary approach for the management of earlier stage renal cell carcinoma.

Transitioning agents that are effective in advanced disease to earlier disease settings is a common pathway for drug development and a concept that has been applied to multiple agents across several tumor types. This approach is relevant in high risk renal cell carcinoma (RCC) where the relapse rate is high. Unfortunately, between 20% and 40% relapse after nephrectomy and approximately one third of patients have evidence of metastasis at initial diagnosis. These patients will proceed with focal or systemic therapy during the course of disease.