Everolimus in the treatment of disseminated renal cancer progressing after therapy with kinase inihibitors

Abstract

At present there is no direct comparison between everolimus and axitinib to assess which one is more effective in patients with uneffective treatment with TKIs. Randomized phase II clinical trial — RECORD-3 may eventually indica­te the proper sequence of axitinib and everolimus in the treatment of patients with metastatic kidney cancer. This trial indicates that the TKI-mTOR sequence is more efficient. The results of two non-interventional, observational, clinical studies also support this concept. The efficacy of axitinib and everolimus (in AXIS and RECORD-1) is compa­rable — PFS is about 5 months, and OS is about 15 months. Everolimus has a different toxicity profile in comparison to axitinib, thus avoiding adverse events associated with treatment with TKIs (accumulation of similar adverse events in the sequence TKI-TKI). Everolimus has a more simple dosage of 10 mg once a day, while axitinib requires the dose modification. While the efficacy of both drugs is comparable, the therapeutic decision should be made on the basis of the profile of drug toxicity and patient’s concomitant diseases.