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A Syngeneic Mouse Model of Metastatic Renal Cell Carcinoma for Quantitative and Longitudinal Assessment of Preclinical Therapies
Published on: April 12, 2017
Non-clear cell renal cancer: features and medical management
Daniel Y C Heng1, Toni K Choueiri
1Tom Baker Cancer Center, Calgary, Alberta, Canada.
Abstract:
The treatment of metastatic renal cell carcinoma (RCC) has changed dramatically with the introduction of targeted therapies against vascular endothelial growth factor and the mammalian target of rapamycin. Because patients with clear cell histology account for more than 80% of patients with RCC, little evidence is available on treating patients with non-clear cell histologies. Most clinical trials have excluded them from enrollment, except for a randomized study investigating temsirolimus. Many retrospective studies on the use of sunitinib, sorafenib, and temsirolimus in patients with non-clear cell histology have shown response rates ranging from 3.7% to 16%. Prospective studies in non-clear cell histologies are ongoing. Although response rates may not be as high as those in patients with clear cell histologies, targeted therapy may provide a clinically meaningful response. New investigational therapies are on the horizon for papillary RCC--the most-common non-clear cell RCC histology--targeting pathways specific to this histology, such as the c-MET pathway.
Insights
Targeted therapies show clinical benefit for metastatic renal cell carcinoma (RCC) with non-clear cell histology, despite lower response rates than clear cell types. New treatments targeting specific pathways are emerging for papillary RCC.
Area of Science:
- Oncology
- Medical Research
Background:
- Metastatic renal cell carcinoma (RCC) treatment has advanced with targeted therapies like anti-vascular endothelial growth factor and anti-mammalian target of rapamycin agents.
- Clear cell histology comprises over 80% of RCC cases, leading to limited evidence for treating non-clear cell histologies.
Purpose of the Study:
- To review the efficacy of targeted therapies in patients with non-clear cell renal cell carcinoma.
- To highlight the potential of emerging therapies for specific non-clear cell RCC subtypes.
Main Methods:
- Review of retrospective studies on sunitinib, sorafenib, and temsirolimus in non-clear cell RCC.
- Analysis of available clinical trial data, noting exclusion of non-clear cell histologies in most trials.
Main Results:
- Retrospective studies reported response rates from 3.7% to 16% for targeted therapies in non-clear cell RCC.
- Targeted therapies may offer clinically meaningful responses, even if not as high as in clear cell RCC.
Conclusions:
- Targeted therapy can provide clinical benefit for non-clear cell RCC, necessitating further investigation.
- Investigational therapies targeting specific pathways, like c-MET for papillary RCC, show promise.
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