Related Experiment Video
Updated: Jun 23, 2026
12:22
The Use of Reverse Phase Protein Arrays (RPPA) to Explore Protein Expression Variation within Individual Renal Cell Cancers
Published on: January 22, 2013
Combination targeted therapy in advanced renal cell carcinoma
1Division of Hematology/Oncology, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, 777 Preston Building, Nashville, TN 37232-6307, USA. jeff.sosman@vanderbilt.edu
Cancer
|April 30, 2009
Summary
Combining targeted therapies for advanced renal cell carcinoma (RCC) shows promise but increases toxicity. Novel combinations targeting VEGF-VEGFR and mTOR pathways require careful management and further study to improve patient outcomes.
Area of Science:
- Oncology
- Nephrology
- Pharmacology
Background:
- Advanced renal cell carcinoma (RCC) treatments have improved but disease progression remains a challenge.
- Novel therapies target pathways like VEGF, VEGFR, and mTOR, downstream of VHL gene loss.
- There is a critical need to increase complete response rates in advanced RCC.
Purpose of the Study:
- To evaluate combination therapy strategies for advanced RCC.
- To assess the clinical activity and toxicity of combining targeted agents.
- To explore vertical blockade (VEGF-VEGFR axis) and horizontal blockade (VEGFR with other receptors) approaches.
Main Methods:
- Review of recent therapeutic approvals and clinical trial experiences.
- Analysis of combination regimens including sorafenib plus bevacizumab, sorafenib with temsirolimus, and sunitinib with temsirolimus or bevacizumab.
- Assessment of response rates and adverse events associated with combination therapies.
Main Results:
- Sorafenib plus bevacizumab showed a 52% response rate (25/48 patients) but increased known toxicities.
- Other combinations required dose reductions or were intolerable.
- Unexpected late toxicity, microangiopathic hemolytic anemia, occurred with sunitinib and bevacizumab.
Conclusions:
- Combination therapy for advanced RCC presents challenges with enhanced toxicity, particularly in patients with compromised renal function.
- Establishing tolerability is crucial before designing Phase 2 trials to compare combination versus sequential therapy.
- Further research is needed to optimize combination regimens for improved efficacy and safety in advanced RCC.
Related Concept Videos
02:57Targeted Cancer Therapies
The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against specific...
There are several types of targeted therapies against specific...
02:57Targeted Cancer Therapies
The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against specific...
There are several types of targeted therapies against specific...
02:50Combination Therapies and Personalized Medicine
Combining two or more treatment methods increases the life span of cancer patients while reducing damage to vital organs or tissue from the overuse of a single treatment. Combination therapy also targets different cancer-inducing pathways, thus reducing the chances of developing resistance to treatment.
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
01:27Tumor Immunotherapy
Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
02:56Treatment Resistent Cancers
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
02:56Treatment Resistant Cancers
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...