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Sequencing systemic therapies in advanced RCC: is there a best strategy?

Tom Powles1, Shanthini M Crusz

  • 1From the Barts Cancer Institute, St Bartholomew's Hospital, Queen Mary University of London, London, United Kingdom.

American Society of Clinical Oncology Educational Book. American Society of Clinical Oncology. Annual Meeting
|May 30, 2013
PubMed

Insights

Sequencing targeted therapies like axitinib and everolimus is crucial for metastatic clear cell renal cancer. Research explores optimal timing and agent selection after first-line vascular endothelial growth factor tyrosine kinase inhibitor failure.

Area of Science:

  • Oncology
  • Medical Research

Background:

  • Metastatic clear cell renal cancer (ccRCC) treatment involves targeted therapies.
  • Optimal sequencing of vascular endothelial growth factor (VEGF) tyrosine kinase inhibitors (TKIs) and other agents remains an area of investigation.

Purpose of the Study:

  • To review current evidence on sequencing targeted therapies in metastatic ccRCC.
  • To discuss the role of axitinib, everolimus, and sorafenib in treatment strategies.

Main Methods:

  • Review of randomized clinical trial data.
  • Analysis of survival outcomes for different treatment sequences.

Main Results:

  • Data support axitinib followed by everolimus after first-line VEGF TKI failure.
  • Everolimus is effective in the second-line setting.
  • Sorafenib shows impressive overall survival in VEGF TKI-resistant disease.

Conclusions:

  • Current sequencing strategies exist but optimal timing and agent choice require further clarification.
  • Cross-resistance among existing agents necessitates the development of novel therapies with new mechanisms of action.

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