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Modeling Spontaneous Metastatic Renal Cell Carcinoma (mRCC) in Mice Following Nephrectomy
Published on: April 29, 2014
Temsirolimus in VEGF-refractory metastatic renal cell carcinoma
M J MacKenzie1, B I Rini2, P Elson2
1Department of Medical Oncology, London Regional Cancer Program, London, Ontario, Canada.
Background:
Temsirolimus is an i.v. administered inhibitor of mammalian target of rapamycin with activity in the first-line setting in poor-prognosis patients with metastatic renal cell carcinoma (RCC). The efficacy of this agent after failure of prior inhibitors of vascular endothelial growth factor (VEGF) is unknown.
Methods:
a retrospective review of patients with metastatic RCC treated at the Cleveland Clinic Taussig Cancer Institute and three regional cancer centers in Ontario, Canada, through the Torisel (temsirolimus) Compassionate Use Program was conducted. Demographic, toxicity and response data were collected.
Results:
a total of 87 patients with metastatic RCC were identified who had previously been treated with inhibitors of VEGF subsequently treated with temsirolimus. The majority of patients had either intermediate or poor-prognosis disease at baseline. Expected toxic effects including hyperglycemia and noninfectious pneumonitis were observed. The RECIST-defined objective response rate was 5% and the stable disease rate was 65%. The median time to progression (TTP) was 3.9 months (95% confidence interval 2.8-4.8 months), and median overall survival was 11.2 months.
Conclusions:
in a cohort of pre-treated intermediate to poor-prognosis patients with metastatic RCC, weekly i.v. temsirolimus is associated with predictable, but manageable toxicity, and a TTP approaching 4 months.
Insights
Temsirolimus showed manageable toxicity in metastatic renal cell carcinoma (RCC) patients previously treated with VEGF inhibitors. The median time to progression was nearly 4 months in this poor-prognosis group.
Area of Science:
- Oncology
- Pharmacology
Background:
- Temsirolimus is an intravenous mTOR inhibitor used in first-line metastatic renal cell carcinoma (RCC).
- Its efficacy after prior vascular endothelial growth factor (VEGF) inhibitor failure was previously unknown.
Purpose of the Study:
- To evaluate the efficacy and toxicity of temsirolimus in metastatic RCC patients who failed prior VEGF inhibitors.
Main Methods:
- Retrospective review of 87 metastatic RCC patients treated with temsirolimus under a compassionate use program.
- Data collected included demographics, toxicity, and objective response rates (RECIST criteria).
Main Results:
- Objective response rate was 5%, with 65% achieving stable disease.
- Median time to progression (TTP) was 3.9 months; median overall survival was 11.2 months.
- Common toxicities included hyperglycemia and noninfectious pneumonitis.
Conclusions:
- Weekly intravenous temsirolimus demonstrates manageable toxicity in pre-treated metastatic RCC patients.
- The treatment provides a time to progression approaching 4 months in this patient population.
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