TY - JOUR
T1 - Second-line therapy for refractory renal-cell carcinoma
AU - Zustovich, Fable
AU - Lombardi, Giuseppe
AU - Nicoletto, Ornella
AU - Pastorelli, Davide
PY - 2012/7
Y1 - 2012/7
N2 - 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.
AB - 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.
KW - Cancer
KW - Kidney
KW - Progression
KW - Target
KW - Therapy
UR - http://www.scopus.com/inward/record.url?scp=84862140730&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84862140730&partnerID=8YFLogxK
U2 - 10.1016/j.critrevonc.2011.08.008
DO - 10.1016/j.critrevonc.2011.08.008
M3 - Article
C2 - 21944739
AN - SCOPUS:84862140730
VL - 83
SP - 112
EP - 122
JO - Critical Reviews in Oncology/Hematology
JF - Critical Reviews in Oncology/Hematology
SN - 1040-8428
IS - 1
ER -