Systemic therapy of metastatic renal cell carcinoma: Review of the current literature

2018 ◽  
Vol 86 (1) ◽  
pp. 3-8 ◽  
Author(s):  
Ioannis Zerdes ◽  
Maria Tolia ◽  
Nikolaos Tsoukalas ◽  
Michail Mitsis ◽  
Dimitrios Kardamakis ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Kinase Inhibitors ◽  
Mammalian Target Of Rapamycin ◽  
Metastatic Setting ◽  
Third Line Therapy ◽  
Third Line ◽  
English Articles

Introduction: Renal cell carcinoma represents a neoplasm with usually aggressive behavior. Due to its nature, it is often diagnosed in an advanced stage or when metastatic dissemination has been occurred. The aim of this review is to provide an overview of the current management of metastatic renal cell carcinoma and briefly discuss the potential new therapeutic strategies for this disease. Methods: Review of the literature was performed in PubMed/MEDLINE, Cochrane, and EMBASE and we included English articles up to February 2018. Results: Over the past years, many efforts have been made in the context of confronting metastatic disease and led to the introduction of targeted therapies. More available agent options, including various tyrosine kinase inhibitors and mammalian target of rapamycin inhibitors, can be served nowadays as the first-, second-, and third-line therapy in the metastatic setting of the disease providing better outcomes. Discussion: Moreover, regarding the recent advances in the field of cancer immunotherapy, the landscape of metastatic renal cell carcinoma management is being shaped toward novel immunotherapeutic interventions alone or in combination with other types of therapy.

Pazopanib as Third Line Therapy for Metastatic Renal Cell Carcinoma: Clinical Efficacy and Temporal Analysis of Cytokine Profile

2015 ◽  
Vol 193 (4) ◽  
pp. 1114-1121 ◽  
Author(s):  
Sumanta Kumar Pal ◽  
Dewan Md Sakib Hossain ◽  
Qifang Zhang ◽  
Paul Henry Frankel ◽  
Jeremy O. Jones ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Clinical Efficacy ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Temporal Analysis ◽  
Cytokine Profile ◽  
Line Therapy ◽  
Third Line Therapy ◽  
Third Line

Paradigm towards Tailored Therapies and Complete Responses in the Treatment of Metastatic Renal Cell Carcinoma

2012 ◽  
Vol 08 (01) ◽  
pp. 30
Author(s):  
Mayer Fishman ◽  
Thomas Hutson ◽  
Neeraj Agarwal ◽  
Eric Jonasch ◽  
◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Kinase Inhibitors ◽  
Mammalian Target Of Rapamycin ◽  
Interleukin 2 ◽  
Standard Of Care ◽  
Complete Response ◽  
High Dose

In recent years, the management of metastatic renal cell carcinoma (mRCC) has been revolutionized by the advent of targeted therapies. Multitargeted kinase inhibitors (such as sunitinib, sorafenib, pazopanib, and axitinib), the vascular endothelial growth factor inhibitor bevacizumab, and mammalian target of rapamycin inhibitors (such as everolimus and temsirolimus) have become the standard of care for the palliation of metastatic disease. Unfortunately, cumulative toxicities and the lack of marked benefits have prevented the combined use of most molecularly targeted agents. Selected patients with mRCC benefit from immunotherapy, as subsets of patients can experience long-term disease remission or complete response with high-dose interleukin-2. In order to optimize the value of immunotherapy, improvements in the selection of drugs and combinations with novel immunomodulatory agents must be pursued.

Third-line therapy in metastatic renal cell carcinoma (mRCC): Results from the International mRCC Database Consortium (IMDC).

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. e15578-e15578
Author(s):  
Daniel Yick Chin Heng ◽  
Igor Stukalin ◽  
Connor Wells ◽  
Frede Donskov ◽  
Brian I. Rini ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Line Therapy ◽  
Third Line Therapy ◽  
Third Line

Efficacy and safety of sequential use of everolimus in patients with metastatic renal cell carcinoma previously treated by bevacizumab with or without interferon therapy: Results from pooled analysis of AVATOR, CHANGE, and TRAIN studies.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 585-585
Author(s):  
Antoine Thiery- Vuillemin ◽  
Aline Guillot ◽  
Thomas Steiner ◽  
Edwin Herrmann ◽  
Konstantinos N. Syrigos ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Kinase Inhibitors ◽  
Mammalian Target Of Rapamycin ◽  
Growth Factor Receptor ◽  
Pooled Analysis ◽  
Second Line ◽  
Line Therapy

585 Background: Everolimus is a mammalian target of rapamycin (mTOR) inhibitor. It gained approval based on the results of the RECORD-1 trial, which included patients with metastatic renal cell carcinoma (mRCC) whose disease progressed after receiving vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKIs). Bevacizumab is a monoclonal antibody targeting angiogenesis that is approved in patients (pts) with mRCC. AVATOR was the 1st study to explore the sequential use of bevacizumab followed by everolimus but with limited number of pts. Methods: In order to further explore this sequence pooled data from the AVATOR, CHANGE and TRAIN studies were analysed retrospectively. All pts had mRCC and were previously or currently treated with everolimus after failure of bevacizumab ± IFN. The primary end point was everolimus time to progression (TTP). Secondary end points were related to the overall survival (OS) of patients receiving the drug sequence, everolimus treatment and safety. Results: 89 pts were included in the analysis. Median age was 68 years [18-90]. At everolimus initiation ECOG was 0-1 for 72% pts and 16% were classified as poor prognosis from Heng classification. Exploring the duration of second-line everolimus treatment, 32% of patients received less than 3 months of everolimus and 35% received at least 6 months of treatment. At the time of data analysis, 20 pts (24%) were still receiving everolimus. Pts receiving everolimus after bevacizumab experienced a median TTP of 6 months [95%CI 4 - 14]. Median OS was not reached for everolimus second-line therapy. At 36 months after the start of first-line therapy, 60.4% of pts were still alive. All grades of common adverse events were consistent with the known safety profile of everolimus. Conclusions: The larger size of this cohort confirms the signal previously seen with AVATOR that the sequence of bevacizumab followed by everolimus displays interesting efficacy with not unexpected toxicity from everolimus and compares favourably with RECORD-1.

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