Second-line therapy for refractory renal-cell carcinoma

Fable Zustovich, Giuseppe Lombardi, Ornella Nicoletto, Davide Pastorelli

Research output: Contribution to journalArticlepeer-review


In the last 5 years inhibitors of the VEGF/VEGFR and mTOR pathways have dramatically changed the therapeutic approach to metastatic renal cancer. Randomized controlled trials have shown that six targeted agents - sorafenib, sunitinib, temsirolimus, bevacizumab, everolimus and pazopanib - are able to improve patient outcome. Even if the choice of drug for first-line therapy is quite well defined, to date it is not easy to characterize and evaluate the efficacy of new therapies in second-line treatment. It is not clear whether, after first-line therapy with a VEGF/VEGFR inhibitor, use of mTOR or a second TKI inhibitor should be recommended. In this review we report on current evidence supporting the use of targeted agents in second-line therapy. Therefore we try to combine current clinical results with a practical clinical approach, with the goal of evaluating the best clinical decision for different clinical situations.

Original languageEnglish
Pages (from-to)112-122
Number of pages11
JournalCritical Reviews in Oncology/Hematology
Issue number1
Publication statusPublished - Jul 2012


  • Cancer
  • Kidney
  • Progression
  • Target
  • Therapy

ASJC Scopus subject areas

  • Oncology
  • Hematology
  • Geriatrics and Gerontology


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