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Free keywords:
ENDOTHELIAL GROWTH-FACTOR; PHASE-III TRIAL; TYROSINE KINASE INHIBITORS;
INTERFERON-ALPHA; TARGETED THERAPY; DOUBLE-BLIND; CYTOREDUCTIVE
NEPHRECTOMY; 1ST-LINE SUNITINIB; TUMOR ANGIOGENESIS; CANCER-PATIENTSRenal cancer; targeted therapy; anti-angiogenesis; vascular endothelial
growth factor; mammalian Target of Rapamycin (mTOR); sunitinib;
bevacizumab; temsirolimus;
Abstract:
The current paradigm in attempting to treat metastatic renal cell carcinoma (mRCC) is a first line treatment with a vascular endothelial growth factor (VEGF) antagonist and second and subsequent treatments with either a vascular endothelial growth factor receptor (VEGFR) or an mTOR (mammalian Target of Rapamycin) inhibitor, while conventional chemotherapeutic and hormonal treatments do not play a role in the management of mRCC. Several drugs directed against VEGF and VEGFR have been developed in recent times. Phase III data validates sunitinib, pazopanib and sorafenib as the best-supported drugs in firstline therapy. Second-line treatment possibilities include axitinib, everolimus and sorafenib. Choosing the right combination of first and second line treatments, however, is difficult, because the success of treatment depends on the precondition of the patient.
