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Updated: Feb 26, 2026

Establishing Dual Resistance to EGFR-TKI and MET-TKI in Lung Adenocarcinoma Cells In Vitro with a 2-step Dose-escalation Procedure
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Establishing Dual Resistance to EGFR-TKI and MET-TKI in Lung Adenocarcinoma Cells In Vitro with a 2-step Dose-escalation Procedure

Published on: August 11, 2017

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The Evolving Treatment Landscape of Advanced Renal Cell Carcinoma in Patients Progressing after VEGF Inhibition

Pedro C Barata1, Moshe C Ornstein1, Jorge A Garcia1,2

  • 1Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA.

Journal of Kidney Cancer and VHL
|July 21, 2017
PubMed

Insights

Most patients with metastatic renal cell carcinoma (RCC) progress after initial vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitor (TKI) therapy. This review guides optimal sequencing of subsequent treatments for advanced RCC.

Area of Science:

  • Oncology
  • Medical Research

Background:

  • Metastatic renal cell carcinoma (mRCC) treatment has evolved, but resistance to first-line therapy remains a challenge.
  • Vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKIs) are standard first-line treatment for mRCC.
  • Patient outcomes are significantly impacted by the choice of subsequent therapies after initial treatment failure.

Purpose of the Study:

  • To review evidence for approved agents used after first-line VEGFR TKI therapy in mRCC.
  • To provide a decision-making framework for sequencing treatments beyond initial VEGFR TKI therapy.
  • To highlight the importance of understanding post-progression treatment options for mRCC.

Main Methods:

  • Systematic literature review of clinical trials and real-world data.
  • Analysis of efficacy and safety data for approved second- and third-line therapies.
  • Synthesis of findings to inform treatment sequencing strategies.

Main Results:

  • Multiple therapeutic options are available for patients progressing on first-line VEGFR TKIs.
  • Data supports various agents, including immunotherapy and targeted therapies, in later lines of treatment.
  • Treatment sequencing decisions should consider patient-specific factors and drug efficacy.

Conclusions:

  • Optimal sequencing of therapies after first-line VEGFR TKI failure is critical for improving outcomes in mRCC.
  • A framework for treatment selection can help clinicians navigate complex therapeutic choices.
  • Further research is needed to refine sequencing strategies and identify predictive biomarkers.
Keywords:
PD-1/PD-L1VEGF inhibitorsadvanced renal cell carcinomaimmunotherapymTOR inhibitorssequential therapy

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