肾细胞癌的治疗前景在过去十年中发生了巨大变化，导致局部和晚期疾病的生存率提高。我们回顾了肾细胞癌的流行病学、病理学和诊断，并讨论了当前从局限性到转移性疾病的治疗策略的证据。讨论了辅助疗法的发展，包括使用派姆单抗（pembrolizumab）——第一种在辅助治疗中实现总体生存获益的疗法。还回顾了晚期疾病的治疗，包括将免疫检查点抑制确立为护理标准的里程碑式试验。我们还讨论了当前围绕转移性肾细胞癌治疗存在的争议，包括使用风险评估模型进行疾病分层和一线治疗的治疗选择。还回顾了非透明细胞肾细胞癌亚型的治疗。还强调了未来的研究方向，包括对正在进行的临床试验的讨论以及对可靠的生物标志物来指导肾癌治疗的需求。Crown 版权所有 © 2024 由 Elsevier Ltd 出版。保留所有权利，包括文本和数据挖掘的权利，人工智能培训和类似技术。

The landscape of the management of renal cell carcinoma has evolved substantially in the last decade, leading to improved survival in localised and advanced disease. We review the epidemiology, pathology, and diagnosis of renal cell carcinoma and discuss the evidence for current management strategies from localised to metastatic disease. Developments in adjuvant therapies are discussed, including use of pembrolizumab-the first therapy to achieve overall survival benefit in the adjuvant setting. The treatment of advanced disease, including landmark trials that have established immune checkpoint inhibition as a standard of care, are also reviewed. We also discuss the current controversies that exist surrounding the management of metastatic renal cell carcinoma, including the use of risk assessment models for disease stratification and treatment selection for frontline therapy. Management of non-clear cell renal cell carcinoma subtypes is also reviewed. Future directions of research, including a discussion of ongoing clinical trials and the need for reliable biomarkers to guide treatment in kidney cancer, are also highlighted.Crown Copyright © 2024 Published by Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.