CONTEXT: The expanding armamentarium of agents for the therapy of advanced clear cell renal cell carcinoma (RCC) warrants further investigation of optimal patient selection. OBJECTIVE: To analyze the second and subsequent line of targeted therapies for advanced RCC while integrating clinical and molecular markers and imaging. EVIDENCE ACQUISITION: Data were acquired from research published in peer-reviewed literature or presented at major conferences. EVIDENCE SYNTHESIS: Following first-line vascular endothelial growth factor (VEGF) inhibitors, second-line therapy with everolimus, a mammalian target of rapamycin inhibitor, and axitinib, a VEGF receptor tyrosine kinase inhibitor, have demonstrated benefits in progression-free survival (PFS). Sorafenib, pazopanib, and axitinib have demonstrated extension of PFS following cytokines. Optimal patient selection based on biomarkers is undergoing investigation. Clinical trials evaluating novel agents and combinations should be preferred. CONCLUSIONS: Currently, the sequence of therapy is based on patient and physician decision, which may be influenced by comorbidities and toxicity profiles.
CONTEXT: The expanding armamentarium of agents for the therapy of advanced clear cell renal cell carcinoma (RCC) warrants further investigation of optimal patient selection. OBJECTIVE: To analyze the second and subsequent line of targeted therapies for advanced RCC while integrating clinical and molecular markers and imaging. EVIDENCE ACQUISITION: Data were acquired from research published in peer-reviewed literature or presented at major conferences. EVIDENCE SYNTHESIS: Following first-line vascular endothelial growth factor (VEGF) inhibitors, second-line therapy with everolimus, a mammalian target of rapamycin inhibitor, and axitinib, a VEGF receptor tyrosine kinase inhibitor, have demonstrated benefits in progression-free survival (PFS). Sorafenib, pazopanib, and axitinib have demonstrated extension of PFS following cytokines. Optimal patient selection based on biomarkers is undergoing investigation. Clinical trials evaluating novel agents and combinations should be preferred. CONCLUSIONS: Currently, the sequence of therapy is based on patient and physician decision, which may be influenced by comorbidities and toxicity profiles.
Authors: Thomas E Hutson; Bernard Escudier; Emilio Esteban; Georg A Bjarnason; Ho Yeong Lim; Kenneth B Pittman; Peggy Senico; Andreas Niethammer; Dongrui Ray Lu; Subramanian Hariharan; Robert J Motzer Journal: J Clin Oncol Date: 2013-12-02 Impact factor: 44.544
Authors: Srikala S Sridhar; Mary J Mackenzie; Sebastien J Hotte; Som D Mukherjee; Ian F Tannock; Nevin Murray; Christian Kollmannsberger; Masoom A Haider; Eric X Chen; Robert Halford; Lisa Wang; S Percy Ivy; Malcolm J Moore Journal: Invest New Drugs Date: 2013-01-26 Impact factor: 3.850
Authors: Christian Rothermundt; Alexandra Bailey; Linda Cerbone; Tim Eisen; Bernard Escudier; Silke Gillessen; Viktor Grünwald; James Larkin; David McDermott; Jan Oldenburg; Camillo Porta; Brian Rini; Manuela Schmidinger; Cora Sternberg; Paul M Putora Journal: Oncologist Date: 2015-08-03
Authors: Jeannette C Oosterwijk-Wakka; Mirjam C A de Weijert; Gerben M Franssen; William P J Leenders; Jeroen A W M van der Laak; Otto C Boerman; Peter F A Mulders; Egbert Oosterwijk Journal: Neoplasia Date: 2015-02 Impact factor: 5.715