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A Syngeneic Mouse Model of Metastatic Renal Cell Carcinoma for Quantitative and Longitudinal Assessment of Preclinical Therapies
Published on: April 12, 2017
Current and Emerging Treatments for Metastatic Renal Cell Carcinoma
Carla Cavaliere1, Carmine D'Aniello1, Chiara Della Pepa2
1Department of Onco-Ematology Medical Oncology, S.G. Moscati Hospital of Taranto, Taranto, Italy.
Abstract:
In the last decades, the treatment of mRCC, metastatic Renal Cell Carcinoma, has become more and more complex due to the approval of a great number of effective systemic treatments that have significantly improved the prognosis of patients suffering from such disease. An additional knowledge of the genetic aberrations and the molecular pathways alterations that underlie RCC, has promoted the development of several novel agents, known as target therapies (TTs). Even though TTs are not curative and all patients eventually progress, an adequate sequencing of these drugs can provide a significant benefit in terms of PFS, Progression Free Survival, and hopefully OS, Overall Survival. To date, there are few data about the optimal sequential use of the TTs hence, in clinical practice, the therapeutic strategy is chosen on the basis of the safety profile of the drug, patients medical history and the pivotal trial results, though such studies often exclude patients with poor performance status and/or severe comorbidities that we routinely see in our clinics. This review aims to provide an overview of the systemic therapies for mRCC both in the newly diagnosed patients and in the subsequent lines of treatment, with a special focus on the last advances about TTs and immunotherapy.
Insights
Systemic treatments have improved metastatic Renal Cell Carcinoma (mRCC) outcomes. This review details targeted therapies (TTs) and immunotherapy sequencing for mRCC patients, optimizing progression-free and overall survival.
Area of Science:
- Oncology
- Medical Genetics
- Pharmacology
Background:
- Metastatic Renal Cell Carcinoma (mRCC) treatment has evolved with numerous effective systemic therapies.
- Advances in understanding genetic aberrations and molecular pathways in RCC have driven the development of targeted therapies (TTs).
- While TTs improve prognosis, they are not curative, and patient progression necessitates strategic sequencing of treatments.
Purpose of the Study:
- To provide a comprehensive overview of systemic therapies for mRCC.
- To focus on the optimal sequencing of targeted therapies (TTs) and immunotherapy in clinical practice.
- To address treatment strategies for both newly diagnosed and advanced mRCC patients, including those with comorbidities.
Main Methods:
- Review of current literature on systemic therapies for mRCC.
- Analysis of pivotal trial data for targeted therapies and immunotherapy.
- Consideration of safety profiles, patient history, and clinical trial exclusions.
Main Results:
- Targeted therapies (TTs) and immunotherapy have significantly improved outcomes in mRCC.
- Optimal sequencing of these agents is crucial for maximizing Progression-Free Survival (PFS) and Overall Survival (OS).
- Clinical practice often relies on drug safety and patient factors due to limited data on sequential TT use.
Conclusions:
- Effective management of mRCC requires a strategic approach to systemic therapy sequencing.
- Understanding molecular pathways aids in selecting appropriate targeted therapies (TTs).
- Further research is needed to establish optimal treatment sequences, especially for patients with poor performance status or comorbidities.
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