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Updated: May 25, 2026
A Syngeneic Mouse Model of Metastatic Renal Cell Carcinoma for Quantitative and Longitudinal Assessment of Preclinical Therapies
Published on: April 12, 2017
Metastatic renal cell carcinoma treated sequentially with multiple VEGF receptor-targeted inhibitors--a case report
Claude Linassier1, Delphine Carmier, Pierre Combe
1Centre Hospitalier Universitaire Bretonneau, Centre Henry S. Kaplan, Department for Oncology, 2 Boulevard Tonnelle, 37044 Tours Cedex 9, France. linassier@med.univ-tours.fr
Abstract:
Six targeted agents [sorafenib, sunitinib, temsirolimus, bevacizumab (plus interferon), everolimus and pazopanib] have been approved for the treatment of patients with metastatic renal cell carcinoma. As disease progression is inevitable, most patients will receive several lines of treatment. However, the choice regarding which sequence of drugs to use remains unclear, particularly concerning the drug class, i.e. those targeting the vascular endothelial growth factor (receptor) [VEGF(R)] pathway versus those acting on the mammalian target of rapamycin pathway. There appears to be no absolute crossresistance between tyrosine kinase inhibitors (TKIs) acting on the VEGF(R) pathway, and there have been numerous reports of two TKIs being successfully used in sequence. We report the case of a 63-year-old woman who responded for 24 months to three successive lines of treatment with different TKIs (sunitinib, axitinib and sorafenib). This suggests that TKIs targeting VEGFR should be considered as individual drugs and not as a single class.
Insights
Metastatic renal cell carcinoma patients often receive multiple treatments. Sequential tyrosine kinase inhibitors targeting vascular endothelial growth factor receptors show promise, suggesting individual drug consideration over class-based approaches.
Area of Science:
- Oncology
- Pharmacology
Background:
- Six targeted agents are approved for metastatic renal cell carcinoma (mRCC).
- Disease progression necessitates multiple treatment lines, but optimal sequencing remains unclear, especially between vascular endothelial growth factor (receptor) [VEGF(R)] and mammalian target of rapamycin (mTOR) pathways.
- Tyrosine kinase inhibitors (TKIs) targeting the VEGF(R) pathway are key treatments for mRCC.
Observation:
- A 63-year-old woman with mRCC received three sequential TKI treatments.
- The patient demonstrated a 24-month response to successive lines of therapy involving sunitinib, axitinib, and sorafenib.
Findings:
- Sequential use of different TKIs targeting the VEGF(R) pathway can be effective in mRCC.
- The study suggests that TKIs targeting VEGF(R) should be viewed as individual agents rather than a single drug class due to potential lack of cross-resistance.
Implications:
- Individualized sequencing of VEGF(R) TKIs may improve treatment outcomes for mRCC patients.
- This case supports the consideration of distinct TKIs in subsequent treatment lines for refractory or progressive mRCC.
- Further research into optimal TKI sequencing strategies is warranted for advanced renal cell carcinoma.
