Related Experiment Video
Updated: Jun 23, 2026
A Syngeneic Mouse Model of Metastatic Renal Cell Carcinoma for Quantitative and Longitudinal Assessment of Preclinical Therapies
Published on: April 12, 2017
Optimal management of metastatic renal cell carcinoma: an algorithm for treatment
Joaquim Bellmunt1, Per Flodgren, Jan Roigas
1Department of Oncology, Lund University Hospital, Lund, Sweden. jbellmunt@imas.imim.es
Abstract:
The treatment of metastatic renal cell carcinoma (mRCC) has been changed by the introduction of targeted agents. Consideration of individual patient factors, such as previous treatment and prognostic risk, e.g. according to the Memorial Sloan-Kettering Cancer Center (MSKCC) risk criteria), can assist in ensuring that patients receive appropriate targeted therapies. Available clinical evidence shows sunitinib to be the reference standard of care for the first-line treatment of mRCC in patients at favourable or intermediate prognostic risk according to MSKCC criteria. Combined treatment with bevacizumab plus interferon-alpha can also be considered for the first-line treatment of mRCC in this setting. For the first-line treatment of poor-risk patients, temsirolimus has shown benefit in a phase III study, while sunitinib can also be considered. For second-line treatment in cytokine-refractory patients, sorafenib is recommended based on phase III trial results; sunitinib has also shown activity after failure of cytokine therapy or targeted agents. As well as antitumour activity, the tolerability of targeted agents should be evaluated in the context of individual patients, considering factors such as comorbidities and age. As our understanding of the activity of targeted agents for mRCC increases, we should ensure that these agents are used appropriately to provide patients with optimal treatment benefits.
Insights
Targeted therapies have transformed metastatic renal cell carcinoma (mRCC) treatment. Personalized approaches considering patient risk factors and drug tolerability optimize outcomes for mRCC patients.
Area of Science:
- Oncology
- Pharmacology
Background:
- Metastatic renal cell carcinoma (mRCC) treatment has evolved with targeted therapies.
- Individual patient factors, including prior treatment and prognostic risk (e.g., Memorial Sloan-Kettering Cancer Center [MSKCC] criteria), are crucial for selecting appropriate therapies.
Purpose of the Study:
- To review the current landscape of targeted agents for mRCC.
- To guide the selection of first- and second-line treatments based on patient risk and treatment history.
- To emphasize the importance of considering drug tolerability alongside efficacy.
Main Methods:
- Review of available clinical evidence and phase III study results for targeted agents in mRCC.
- Analysis of treatment recommendations based on prognostic risk criteria (MSKCC).
- Evaluation of efficacy and tolerability data for various targeted therapies.
Main Results:
- Sunitinib is a reference standard for first-line treatment in favorable/intermediate MSKCC risk mRCC.
- Bevacizumab plus interferon-alpha is an option for first-line treatment in this group.
- Temsirolimus and sunitinib show benefit in first-line treatment for poor-risk mRCC patients.
- Sorafenib is recommended for second-line treatment in cytokine-refractory patients; sunitinib also shows activity.
- Tolerability, comorbidities, and age are key factors in agent selection.
Conclusions:
- Targeted agents have significantly improved mRCC treatment outcomes.
- Personalized treatment selection based on risk stratification and tolerability is essential for optimal patient benefit.
- Continued understanding of targeted agent activity will refine mRCC management strategies.
Related Concept Videos
01:30Urinary Tract Calculi III: Medical Management
01:28Chronic Kidney Disease III: Interprofessional Care
01:28Urinary Tract Calculi V: Nursing Management
01:18Chronic Kidney Disease IV: Nursing Management
01:20Acute Kidney Injury V: Interprofessional Care
01:27Urinary Tract Calculi IV: Nutrition Therapy and Prevention