TITLE

Current Management of Advanced and Metastatic Renal Cell Carcinoma

AUTHOR(S)
Ather, M. Hammad; Masood, Nehal; Siddiqui, Tahmeena
PUB. DATE
January 2010
SOURCE
Urology Journal;Nov2010, Vol. 7 Issue 1, p1
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Introduction: Unresectable renal cell carcinoma (RCC) is a technically incurable condition. Historically, RCC is resistant to chemotherapy and radiotherapy. Cytokine therapy was until recently considered the mainstay of treatment. However, responses are modest. Improvement in the understanding of the biology of RCC, particularly the hereditary types, is providing the basis for novel therapeutic targets. Our aim was to review the clinical utility of various systemic agents and surgery in the management of advanced RCC and suggest practice guidelines in the light of current literature. Materials and Methods: Evidence was collected by review of current literature, guidelines of the American and European associations and the national comprehensive cancer network. Results: Treatment of advanced RCC has recently undergone a major change with the development of targeted agents and potent angiogenesis inhibitors. Small-molecule multikinase inhibitors that target vascular endothelial growth factor receptors have a favorable toxicity profile and can prolong time to progression and preserve quality of life when used in newly diagnosed or previously treated patients; bevacizumab enhances the response rate and prolongs disease control when added to interferon-a. Temsirolimus, a mammalian target of rapamycin inhibitor, prolongs the survival duration of patients with poor-risk disease. All currently available agents have variable toxicity profile and they, at best, improve survival by a few months. Surgery still has a significant role in the management of stage IV RCC. Conclusion: Supportive care and surgery remain the mainstay of treatment even in the management of advanced and metastatic RCC. Systemic therapeutic agents are showing promising results.
ACCESSION #
48637361

 

Related Articles

  • Anti-Angiogenesis Therapy in the Treatment of Non-Small Cell Lung Cancer: The Role of Monoclonal Antibodies and Multitargeted Tyrosine Kinase Inhibitors. Stinchcombe, Thomas E. // European Journal of Clinical & Medical Oncology;2010, Vol. 2 Issue 1, p23 

    Treatment with cytotoxic chemotherapy has reached a therapeutic plateau in advanced-stage non-small cell lung cancer (NSCLC), and the development of anti-angiogenesis therapy has become an area of intense investigation. Bevacizumab, a monoclonal antibody against vascular endothelial growth...

  • Targeting vascular endothelial growth factor (VEGF)-receptor-signaling in renal cell carcinoma. Reuter, Christoph W. M.; Morgan, Michael A.; Grünwald, Viktor; Herrmann, Thomas R. W.; Burchardt, Martin; Ganser, Arnold // World Journal of Urology;Feb2007, Vol. 25 Issue 1, p59 

    Metastatic renal cell carcinoma (RCC) is resistant to conventional chemotherapy. Combined data for a variety of immunotherapies resulted in an overall chance of partial (PR) or complete remission (CR) of only 12.9%. There is a clear need for novel, more effective therapies to prevent relapse,...

  • Acceleration of clear cell renal cell carcinoma growth in mice following bevacizumab/Avastin treatment: the role of CXCL cytokines. Grepin, R; Guyot, M; Jacquin, M; Durivault, J; Chamorey, E; Sudaka, A; Serdjebi, C; Lacarelle, B; Scoazec, J-Y; Negrier, S; Simonnet, H; Pages, G // Oncogene;3/29/2012, Vol. 31 Issue 13, p1683 

    The anti-VEGF targeted antibody bevacizumab (BVZ) has been approved for treating renal cell carcinomas (RCCs). Although BVZ increases the progression-free survival of patients with metastatic RCC, the effect on overall survival is poor. To gain insight into the limited efficacy of BVZ on overall...

  • Targeted-Therapy in Advanced Renal Cell Carcinoma. Pirrotta, M. T.; Bernardeschi, P.; Fiorentini, G. // Current Medicinal Chemistry;Apr2011, Vol. 18 Issue 11, p1651 

    No abstract available.

  • Treatment of everolimus-resistant metastatic renal cell carcinoma with VEGF-targeted therapies. Grünwald, V; Seidel, C; Fenner, M; Ganser, A; Busch, J; Weikert, S // British Journal of Cancer;11/22/2011, Vol. 105 Issue 11, p1635 

    Background:Treatment of everolimus-resistant disease remains largely undefined in metastatic renal cell carcinoma (mRCC). We report on 40 patients (pts) who receive systemic treatment after failure of everolimus.Patients and methods:Forty pts received sunitinib (n=19), sorafenib (n=8), dovitinib...

  • Targeted agents in metastatic Xp11 translocation/TFE3 gene fusion renal cell carcinoma (RCC): a report from the Juvenile RCC Network. Malouf, G. G.; Camparo, P.; Oudard, S.; Schleiermacher, G.; Theodore, C.; Rustine, A.; Dutcher, J.; Billemont, B.; Rixe, O.; Bompas, E.; Guillot, A.; Boccon-Gibod, L.; Couturier, J.; Molinié, V.; Escudier, B. // Annals of Oncology;Sep2010, Vol. 21 Issue 9, p1834 

    Background: Xp11 translocation renal cell carcinoma (RCC) is an RCC subtype affecting 15% of RCC patients <45 years. We analyzed the benefit of targeted therapy [vascular endothelial growth factor receptor (VEGFR)-targeted agents and/or mammalian target of rapamycin (mTOR) inhibitors] in these...

  • Axitinib for the Management of Metastatic Renal Cell Carcinoma. Escudier, Bernard; Gore, Martin // Drugs in R&D;2011, Vol. 11 Issue 2, p113 

    In recent years, targeted agents have changed the treatment landscape for patients with advanced renal cell carcinoma (RCC), greatly improving treatment outcomes. Several targeted agents are now licensed for the treatment of metastatic RCC (mRCC), and a number of new agents are under...

  • The role of surgery for metastatic renal cell carcinoma in the era of targeted therapies. Bigot, Pierre; Lebdai, Souhil; Ravaud, Alain; Azzouzi, Abdel Rahmène; Ferrière, Jean-Marie; Patard, Jean-Jacques; Bernhard, Jean-Christophe // World Journal of Urology;Dec2013, Vol. 31 Issue 6, p1383 

    Purpose: With the emergence of targeted therapies, the indications of cytoreductive nephrectomy have to be redefined. This review article presents the evidence data guiding our current indications of surgery in the management of metastatic renal cell carcinoma (mRCC) in the era of targeted...

  • Influence of bevacizumab, sunitinib and sorafenib as single agents or in combination on the inhibitory effects of VEGF on human dendritic cell differentiation from monocytes. Alfaro, C.; Suarez, N.; Gonzalez, A.; Solano, S.; Erro, L.; Dubrot, J.; Palazon, A.; Hervas-Stubbs, S.; Gurpide, A.; Lopez-Picazo, J. M.; Grande-Pulido, E.; Melero, I.; Perez-Gracia, J. L. // British Journal of Cancer;4/7/2009, Vol. 100 Issue 7, p1111 

    Vascular endothelial growth factor (VEGF) inhibits differentiation and maturation of dendritic cells (DC), suggesting a potential immunosuppressive role for this proangiogenic factor. Bevacizumab, sorafenib and sunitinib target VEGF-mediated angiogenesis and are active against several types of...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics