A comprehensive overview of targeted therapy in metastatic renal cell carcinoma

Z Mihaly1, Z Sztupinszki, P Surowiak

  • 1Research Laboratory for Pediatrics and Nephrology, Hungarian Academy of Sciences - Semmelweis University 1st Dept. of Pediatrics, Wrocaw University School of Medicine, ul. Chaubińskiego 6a, 50-356 Wrocaw, Poland

Insights

Systemic treatments for metastatic renal cell carcinoma, including chemotherapy and immunotherapy, show limited success. Current therapies target the RAS pathway, with ongoing trials exploring novel kinase inhibitors and antibodies for improved survival benefits.

Area of Science:

  • Oncology
  • Pharmacology

Background:

  • Metastatic renal cell carcinoma (mRCC) systemic treatment remains challenging, with chemotherapy and immunotherapy yielding suboptimal results.
  • Current standard therapies primarily target the RAS signal transduction pathway, including vascular endothelial growth factor inhibitors, mTOR inhibitors, and multi-targeted receptor tyrosine kinase inhibitors.

Purpose of the Study:

  • To provide a comprehensive overview of current advances in the systemic treatment of metastatic renal cell carcinoma.
  • To review clinical investigation results focusing on survival benefits of existing and novel therapeutic agents.

Main Methods:

  • Review of published clinical investigation results for established mRCC therapies.
  • Inclusion of follow-up and interim results from ongoing clinical trials of new agents.
  • Discussion of emerging therapies including kinase inhibitors (axitinib, tivozanib, dovitinib, cediranib) and monoclonal antibodies (velociximab).

Main Results:

  • Established first-line therapies include sunitinib, temsirolimus, pazopanib, and bevacizumab plus interferon α.
  • Second-line treatment options comprise everolimus and tyrosine kinase inhibitors for patients previously treated with cytokines.
  • Emerging agents show promise, with ongoing trials evaluating their efficacy and survival impact.

Conclusions:

  • Current systemic treatments for mRCC offer survival benefits but are not always decisive.
  • Novel kinase inhibitors and monoclonal antibodies represent promising future directions in mRCC therapy.
  • Continuous evaluation of clinical trial data is crucial for advancing mRCC treatment strategies.

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