Clinical Report: Consensus Guidelines for the Management of Locally Advanced and Metastatic RCC

Overview

The Hong Kong Urological Association and the Hong Kong Society of Uro-Oncology have updated their consensus guidelines for the management of locally advanced and metastatic renal cell carcinoma (RCC). Key updates include the endorsement of adjuvant therapy for locally advanced RCC and the introduction of immunotherapy-based combination therapies for metastatic RCC.

Background

Renal cell carcinoma (RCC) is a significant global health concern, with increasing incidence rates, particularly in developed regions. The prognosis for patients with locally advanced (la)RCC and metastatic (m)RCC is poor, necessitating optimized treatment strategies. Recent advancements in therapies, including immunotherapy and targeted agents, highlight the need for updated clinical guidelines to improve patient outcomes.

Data Highlights

A total of 42 consensus statements were accepted, reflecting contemporary management strategies for la/mRCC.

Key Findings

• Adjuvant therapy is now recommended for locally advanced RCC.
• Immunotherapy-based combination therapies are endorsed for various types of metastatic RCC.
• Active surveillance is suggested for mRCC patients with very favorable prognosis.
• Belzutifan is recognized as a novel therapeutic agent for metastatic RCC.
• Definitions and management strategies for oligometastatic and oligoprogressive RCC have been established.

Clinical Implications

Clinicians should consider the updated consensus statements when managing patients with locally advanced and metastatic RCC. The incorporation of adjuvant therapy and immunotherapy combinations into treatment plans may enhance patient outcomes and survival rates.

Conclusion

The updated consensus guidelines provide a comprehensive framework for the management of locally advanced and metastatic RCC, reflecting the latest evidence and therapeutic advancements. These guidelines serve as a valuable resource for clinicians in Hong Kong and the Asia-Pacific region.

References

1. Hong Kong Urological Association, Hong Kong Society of Uro-Oncology, 2025 -- Consensus Guidelines for the Management of Locally Advanced and Metastatic RCC
2. The ASCO Post — ASCO Releases First Comprehensive Evidence-Based Guidelines for Metastatic Clear Cell Renal Cell Carcinoma
3. Recommendations from the German S3 Guidelines on Diagnostic and Prognostic Assessment in Renal Cell Tumors
4. The ASCO Post — NCCN Clinical Practice Guidelines in Oncology: 2024 Updates
5. The ASCO Post — NCCN Clinical Practice Guidelines: Important Updates for 2012
6. ASCO Releases First Comprehensive Evidence-Based Guidelines for Metastatic Clear Cell Renal Cell Carcinoma
7. Recommendations from the German S3 Guidelines on Diagnostic and Prognostic Assessment in Renal Cell Tumors
8. NCCN Clinical Practice Guidelines in Oncology: 2024 Updates
9. Renal cell carcinoma: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up
10. Pembrolizumab plus axitinib versus sunitinib for advanced clear cell renal cell carcinoma: 5-year survival and biomarker analyses of the phase 3 KEYNOTE-426 trial | Nature Medicine
11. Atezolizumab plus cabozantinib versus cabozantinib monotherapy for patients with renal cell carcinoma after progression with previous immune checkpoint inhibitor treatment (CONTACT-03): a multicentre, randomised, open-label, phase 3 trial - ScienceDirect