Neoadjuvant Targeted Molecular Therapy Before Renal Surgery.

Neoadjuvant targeted molecular therapy may benefit select patients with metastatic renal cell carcinoma. The primary use of this therapy in patients with metastatic disease is to reduce tumor burden, prevent distant metastasis, and increase overall survival. Neoadjuvant therapy may reduce tumor size and tumor complexity, facilitate partial nephrectomy rather than radical nephrectomy, downstage tumor thrombus facilitating thrombectomy, and make unresectable tumors resectable when applied to selected patients. These potential benefits of neoadjuvant therapy require further clinical trials to better define the renal function and oncological and survival outcomes in patients receiving each active agent.