[Current aspects of second-line and sequence therapy of metastatic renal cell carcinoma]

Area of Science:

• Oncology
• Pharmacology

Background:

• Metastatic renal cell carcinoma (RCC) treatment focuses on delaying progression and preserving quality of life.
• The emergence of targeted therapies necessitates strategic sequencing for optimal patient outcomes.

Purpose of the Study:

• To provide evidence-based recommendations for sequential targeted therapy in metastatic RCC.
• To outline treatment algorithms based on current data and clinical guidelines.

Main Methods:

• Review of current data, national and international guidelines, and therapeutic algorithms.
• Analysis of efficacy data for various targeted therapies in sequential treatment settings.

Main Results:

• Cytokine therapy shows limited efficacy after failure of prior cytokine treatment.
• Sorafenib or Sunitinib are recommended as first-line treatments post-cytokine failure.
• Everolimus is the preferred agent after vascular endothelial growth factor (VEGF)-directed therapy failure.
• Other tyrosine kinase inhibitors (TKIs) demonstrate activity and can be considered as alternatives.

Conclusions:

• Sequential targeted therapy is a key strategy in managing metastatic RCC.
• Treatment decisions should be guided by prior therapy, drug efficacy, and clinical guidelines.
• Ongoing clinical studies are vital for refining sequential treatment approaches in RCC.