Targeted therapy for renal cell carcinoma: focus on 2nd and 3rd line

Camillo Porta, Palma Giglione, Chiara Paglino

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Introduction: Second- and third-line treatments are more and more frequently administered to metastatic renal cell carcinoma (mRCC) patients. Areas covered: Here we discuss the various levels of evidence supporting presently available recommendations, trying to address a number of as yet unanswered issues, and also to take a glowing glance at the future. To do this, we interrogated the Medline database, as well as the proceedings of the main Oncological and Urological conferences for relevant studies. Expert opinion: Until recently, with regard to choosing the second line treatment after the failure of therapy with vascular endothelial growth factor receptors-tyrosine kinase inhibitors (VEGFR-TKIs), the continued inhibition of the VEGF/VEGR pathway, or else the switch to an mTOR inhibitor, is recommended. These two options are characterized by partly different targets, completely different toxicity profiles, but a comparable efficacy. This scenario will change soon, after the publication of two randomized, controlled, phase III trials in which cabozantinib and nivolumab proved to be superior as compared to everolimus. As regards third line treatment, where a sequence of two VEGFR-TKIs has been used beforehand, the choice is represented by the mTOR inhibitor everolimus, whilst if a VEGFR-TKI followed by everolimus has been chosen, a return to VEGF pathway inhibition is suggested.

Original languageEnglish
Pages (from-to)1-13
Number of pages13
JournalExpert Opinion on Pharmacotherapy
DOIs
Publication statusAccepted/In press - Jan 7 2016

Fingerprint

Vascular Endothelial Growth Factor Receptor
Renal Cell Carcinoma
Protein-Tyrosine Kinases
Vascular Endothelial Growth Factor A
Expert Testimony
Treatment Failure
Publications
Therapeutics
Databases
Everolimus

Keywords

  • Renal cell carcinoma
  • second-line therapy
  • targeted agents
  • third-line therapy

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology

Cite this

Targeted therapy for renal cell carcinoma : focus on 2nd and 3rd line. / Porta, Camillo; Giglione, Palma; Paglino, Chiara.

In: Expert Opinion on Pharmacotherapy, 07.01.2016, p. 1-13.

Research output: Contribution to journalArticle

@article{5504e3693e0a4bfbabd51c4f4c19540c,
title = "Targeted therapy for renal cell carcinoma: focus on 2nd and 3rd line",
abstract = "Introduction: Second- and third-line treatments are more and more frequently administered to metastatic renal cell carcinoma (mRCC) patients. Areas covered: Here we discuss the various levels of evidence supporting presently available recommendations, trying to address a number of as yet unanswered issues, and also to take a glowing glance at the future. To do this, we interrogated the Medline database, as well as the proceedings of the main Oncological and Urological conferences for relevant studies. Expert opinion: Until recently, with regard to choosing the second line treatment after the failure of therapy with vascular endothelial growth factor receptors-tyrosine kinase inhibitors (VEGFR-TKIs), the continued inhibition of the VEGF/VEGR pathway, or else the switch to an mTOR inhibitor, is recommended. These two options are characterized by partly different targets, completely different toxicity profiles, but a comparable efficacy. This scenario will change soon, after the publication of two randomized, controlled, phase III trials in which cabozantinib and nivolumab proved to be superior as compared to everolimus. As regards third line treatment, where a sequence of two VEGFR-TKIs has been used beforehand, the choice is represented by the mTOR inhibitor everolimus, whilst if a VEGFR-TKI followed by everolimus has been chosen, a return to VEGF pathway inhibition is suggested.",
keywords = "Renal cell carcinoma, second-line therapy, targeted agents, third-line therapy",
author = "Camillo Porta and Palma Giglione and Chiara Paglino",
year = "2016",
month = "1",
day = "7",
doi = "10.1517/14656566.2016.1127353",
language = "English",
pages = "1--13",
journal = "Expert Opinion on Pharmacotherapy",
issn = "1465-6566",
publisher = "Taylor and Francis Ltd.",

}

TY - JOUR

T1 - Targeted therapy for renal cell carcinoma

T2 - focus on 2nd and 3rd line

AU - Porta, Camillo

AU - Giglione, Palma

AU - Paglino, Chiara

PY - 2016/1/7

Y1 - 2016/1/7

N2 - Introduction: Second- and third-line treatments are more and more frequently administered to metastatic renal cell carcinoma (mRCC) patients. Areas covered: Here we discuss the various levels of evidence supporting presently available recommendations, trying to address a number of as yet unanswered issues, and also to take a glowing glance at the future. To do this, we interrogated the Medline database, as well as the proceedings of the main Oncological and Urological conferences for relevant studies. Expert opinion: Until recently, with regard to choosing the second line treatment after the failure of therapy with vascular endothelial growth factor receptors-tyrosine kinase inhibitors (VEGFR-TKIs), the continued inhibition of the VEGF/VEGR pathway, or else the switch to an mTOR inhibitor, is recommended. These two options are characterized by partly different targets, completely different toxicity profiles, but a comparable efficacy. This scenario will change soon, after the publication of two randomized, controlled, phase III trials in which cabozantinib and nivolumab proved to be superior as compared to everolimus. As regards third line treatment, where a sequence of two VEGFR-TKIs has been used beforehand, the choice is represented by the mTOR inhibitor everolimus, whilst if a VEGFR-TKI followed by everolimus has been chosen, a return to VEGF pathway inhibition is suggested.

AB - Introduction: Second- and third-line treatments are more and more frequently administered to metastatic renal cell carcinoma (mRCC) patients. Areas covered: Here we discuss the various levels of evidence supporting presently available recommendations, trying to address a number of as yet unanswered issues, and also to take a glowing glance at the future. To do this, we interrogated the Medline database, as well as the proceedings of the main Oncological and Urological conferences for relevant studies. Expert opinion: Until recently, with regard to choosing the second line treatment after the failure of therapy with vascular endothelial growth factor receptors-tyrosine kinase inhibitors (VEGFR-TKIs), the continued inhibition of the VEGF/VEGR pathway, or else the switch to an mTOR inhibitor, is recommended. These two options are characterized by partly different targets, completely different toxicity profiles, but a comparable efficacy. This scenario will change soon, after the publication of two randomized, controlled, phase III trials in which cabozantinib and nivolumab proved to be superior as compared to everolimus. As regards third line treatment, where a sequence of two VEGFR-TKIs has been used beforehand, the choice is represented by the mTOR inhibitor everolimus, whilst if a VEGFR-TKI followed by everolimus has been chosen, a return to VEGF pathway inhibition is suggested.

KW - Renal cell carcinoma

KW - second-line therapy

KW - targeted agents

KW - third-line therapy

UR - http://www.scopus.com/inward/record.url?scp=84953312382&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84953312382&partnerID=8YFLogxK

U2 - 10.1517/14656566.2016.1127353

DO - 10.1517/14656566.2016.1127353

M3 - Article

C2 - 26630127

AN - SCOPUS:84953312382

SP - 1

EP - 13

JO - Expert Opinion on Pharmacotherapy

JF - Expert Opinion on Pharmacotherapy

SN - 1465-6566

ER -