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Assessment of Resistance to Tyrosine Kinase Inhibitors by an Interrogation of Signal Transduction Pathways by Antibody Arrays
Published on: September 19, 2018
Third generation tyrosine kinase inhibitors and their development in advanced renal cell carcinoma
1Cleveland Clinic Taussig Cancer Center, Cleveland Clinic Lerner College of Medicine of CWRU Pepper Pike, OH, USA.
Abstract:
Angiogenesis in general and the vascular endothelial growth factor (VEGF) signaling axis in particular is a validated target in renal cell carcinoma (RCC). Clear-cell carcinoma of the kidney is now recognized as a malignancy that is sensitive to inhibitors of the VEGF pathway. Treatment options for patients with metastatic renal cell carcinoma have evolved in dramatic fashion over the past 6 years, and a new paradigm has developed. The cytokines interferon-α and interleukin-2 were previously utilized for therapy, but since December 2005, six new agents have been approved in the United States for the treatment of advanced RCC. Two are tyrosine kinase inhibitors (TKI's) including sunitinib and recently pazopanib, and the multikinase inhibitor sorafenib. The current review examines the evolving data with the next generation of TKI's, axitinib and tivozanib being developed for the treatment of advanced RCC. These agents were synthesized to provide increased target specificity and enhanced target inhibition. The preclinical and clinical data are examined, an overview of the development of these TKI's is provided, and discussion plus speculation concerning their potential roles as RCC therapy is provided.
Insights
Next-generation tyrosine kinase inhibitors (TKIs) targeting the vascular endothelial growth factor (VEGF) pathway show promise for advanced renal cell carcinoma (RCC). These TKIs offer enhanced specificity and inhibition for improved treatment strategies.
Area of Science:
- Oncology
- Pharmacology
Background:
- The vascular endothelial growth factor (VEGF) signaling pathway is a validated therapeutic target in renal cell carcinoma (RCC).
- Clear-cell kidney carcinoma demonstrates sensitivity to VEGF pathway inhibitors.
- Recent years have seen a paradigm shift in advanced RCC treatment, with six new agents approved since 2005.
Purpose of the Study:
- To review the evolving data on next-generation tyrosine kinase inhibitors (TKIs) for advanced RCC.
- To examine preclinical and clinical data for axitinib and tivozanib.
- To provide an overview of TKI development and discuss their potential roles in RCC therapy.
Main Methods:
- Review of preclinical and clinical data for axitinib and tivozanib.
- Examination of the development of next-generation TKIs.
- Discussion of potential therapeutic roles in advanced RCC.
Main Results:
- The development of next-generation TKIs like axitinib and tivozanib aims for increased target specificity and enhanced inhibition.
- These agents represent an evolution from earlier therapies like interferon-α and interleukin-2, and initial TKIs such as sunitinib, pazopanib, and sorafenib.
Conclusions:
- Next-generation TKIs are being developed to offer improved efficacy and specificity in treating advanced RCC.
- Further investigation into axitinib and tivozanib is warranted to define their role in the evolving treatment landscape of RCC.
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