Targeted therapy for metastatic renal cell carcinoma: current treatment and future directions

Daniel Y C Heng1, Christian Kollmannsberger, Kim N Chi

  • 1BC Cancer Agency, 600 West 12 Avenue, Vancouver, British Columbia, V5Z 4E6, Canada.

Insights

Targeted therapies targeting vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTOR) pathways have transformed metastatic renal cell carcinoma (RCC) treatment, largely replacing immunotherapy. New agents and combination strategies are under investigation.

Area of Science:

  • Oncology
  • Molecular Biology
  • Pharmacology

Background:

  • Metastatic renal cell carcinoma (RCC) treatment has evolved significantly.
  • Vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTOR) pathways are key targets in RCC therapy.
  • Targeted therapies have largely replaced immunotherapy as the standard of care for advanced RCC.

Purpose of the Study:

  • To review the current landscape of targeted therapies for metastatic RCC.
  • To discuss emerging targeted agents and treatment strategies.
  • To highlight ongoing clinical trials exploring new therapeutic approaches.

Main Methods:

  • Review of phase III randomized trials.
  • Analysis of approved anti-VEGF and mTOR-targeted agents.
  • Discussion of novel targeted therapies and inhibitors in development.
  • Examination of ongoing clinical trials for combination and sequential therapies.

Main Results:

  • Anti-VEGF agents (sunitinib, sorafenib, bevacizumab) and mTOR inhibitors (temsirolimus, everolimus) are established treatments.
  • New targeted therapies including axitinib, pazopanib, and c-met inhibitors show promise.
  • Sequential and combination targeted therapies are under investigation for advanced disease.

Conclusions:

  • Targeted therapies targeting VEGF and mTOR pathways have revolutionized metastatic RCC treatment.
  • Ongoing research focuses on expanding treatment options with novel agents and strategies.
  • Adjuvant and neoadjuvant approaches around nephrectomy are also being explored.

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