Beyond the Scalpel: the Role of Image-Guided Thermal Ablation in Management of Metastatic Renal Cell Carcinoma in the Era of Immunotherapy

Abstract

Renal cell carcinoma (RCC) is the most common type of kidney cancer and accounts for approximately 90% of all renal malignancies. About 30% of patients have metastatic disease at their initial presentation. Historically, these patients have very poor prognosis with a median survival of 12 months. The recent introduction of immune checkpoint inhibitors (ICI)-based immunotherapy, which disrupts cancer-induced immune tolerance and promotes immune-mediated cancer cell killing, has significantly improved patient outcome. While ICI-based therapy represents the standard of care for metastatic RCC, there are significant treatment-related adverse effects. This review article will examine how image-guided ablation, as an adjunct to immunotherapy, can improve survival and quality of life in patients with metastatic RCC.