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Everolimus for the treatment of advanced renal cell carcinoma
1UT Medical School at Houston -- Internal Medicine, Division of Oncology, Houston, TX 77030, USA. robert.amato@uth.tmc.edu
Introduction:
The efficacy of sequential everolimus (RAD001, Afinitor®), an orally administered inhibitor of mammalian target of rapamycin (mTOR), is one of the therapeutic options in patients with advanced renal cell cancer (RCC). The purpose of this review is to discuss the mTOR pathway and to update current knowledge of the role of everolimus in metastatic RCC.
Areas Covered:
The function of mTOR and its inhibition, the early development trials of everolimus, the Phase II trial that lead to the Phase III study and ultimately to FDA approval are all discussed in this review. Literature utilized for this review consists of PUBMED for both description of the mTOR pathway and its role, in addition to publications using everolimus in RCC.
Expert Opinion:
Everolimus is currently the only agent with a proven progression-free survival improvement for patients who progressed on a vascular endothelial growth factor receptor-tyrosine kinase inhibitor. Future studies may further shed light on the most optimal use of everolimus.
Insights
Everolimus is a key treatment for advanced renal cell cancer (RCC) patients who have progressed on prior therapies. This review details its role in metastatic RCC, highlighting improved progression-free survival.
Area of Science:
- Oncology
- Pharmacology
Background:
- Advanced renal cell cancer (RCC) presents significant treatment challenges.
- Mammalian target of rapamycin (mTOR) pathway inhibitors offer a therapeutic option.
Purpose of the Study:
- To review the mTOR pathway and its inhibition.
- To update knowledge on everolimus in metastatic RCC.
Main Methods:
- Literature review using PubMed.
- Analysis of early development, Phase II, and Phase III trials of everolimus.
- Inclusion of publications on mTOR pathway and everolimus in RCC.
Main Results:
- Everolimus is an orally administered mTOR inhibitor.
- Clinical trials demonstrate its efficacy in specific RCC patient populations.
Conclusions:
- Everolimus is the sole agent with demonstrated progression-free survival benefit for patients progressing on VEGF-TKI therapy.
- Further research is needed to optimize everolimus utilization in RCC treatment.
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