Current management of metastatic renal cell carcinoma: evolving new therapies

Area of Science:

• Oncology
• Medical treatment of cancer
• Renal cell carcinoma research

Background:

• Cytokine treatments are no longer the gold standard for metastatic renal cell carcinoma (mRCC).
• Targeted therapies, including tyrosine kinase inhibitors, VEGF inhibitors, mTOR inhibitors, and immunotherapies, are now the standard of care.
• Current treatments for mRCC include sunitinib, pazopanib, axitinib, sorafenib, cabozantinib, lenvatinib, bevacizumab, everolimus, temsirolimus, and nivolumab.

Purpose of the Study:

• To provide an updated analysis of clinical data for targeted therapies in mRCC.
• To review the efficacy and tolerability of agents in the first-line and second-line settings for mRCC management.

Main Methods:

• Review of clinical data for approved targeted therapies in mRCC.
• Analysis of first-line and second-line treatment settings.

Main Results:

• In the first-line setting, pazopanib may offer better tolerability than sunitinib; individualized sunitinib dosing may improve survival; cabozantinib is an emerging option.
• In the second-line setting, cabozantinib, lenvatinib/everolimus, and nivolumab demonstrate superiority over everolimus.
• The International Metastatic RCC Database Consortium prognostic model can aid in selecting subsequent therapies.

Conclusions:

• Targeted therapies are the established standard for mRCC treatment.
• Despite improvements, current targeted therapies are largely noncurative for mRCC.
• Further research into RCC oncogenic pathways and ongoing clinical trials are crucial for optimizing mRCC management.