Background: The kidneys are vital organs acting as the body’s filters that eliminate drugs and other
waste products from the body. For effective cancer therapy, a delicate balance is required in the drug treatment
and its elimination, which is critical for drug accumulation, toxicity, and kidney malfunction. However, how renal
cell carcinoma (RCC) affects the kidneys in safely eliminating the byproducts of drug treatments in patients
with severely dysregulated kidney functions had remained elusive. Recent advancements in dose adjustment
have added to our understanding regarding how drug treatments could be effectively regulated in aberrant kidney
cells, driving safe elimination and reducing drug accumulation and toxicity at the right time and space.
Dose adjustment is the only standard systemic way applicable; however, it presents certain limitations. There is
significant room for developing new strategies and alternatives to improve it.
Objectives: Our analysis of the available treatments in literature discusses the treatment and their safe eliminations.
In this study, we give an overview of the measures that could be taken to maintain the elimination gradient
of anti-cancer drugs and restore normal kidney function in RCC. Differential therapeutics of RCC/mRCC in
various clinical phase trials and the interaction of targeted therapeutics in response to vascular endothelial
growth factor (VEGF) were also discussed.
Conclusion: Such information might suggest a new direction in controlling treatment with safe elimination
through dose adjustment and its associated alternatives in a judicious manner. A strategy to systematically focus
on the safe elimination of anti-cancer drugs in RCC strongly needs advocating.