open access

Vol 7, No 3 (2011)
Review paper
Published online: 2011-08-23
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Renal-cell carcinoma — current options for the second-line treatment with specific focus on the role of everolimus

Piotr J. Wysocki, Jakub Żołnierek, Krzysztof Krzemieniecki, Kazimierz Drosik, Piotr Potemski, Maciej Krzakowski
Onkol. Prak. Klin 2011;7(3):113-118.

open access

Vol 7, No 3 (2011)
REVIEW ARTICLES
Published online: 2011-08-23

Abstract

For many years treatment of advanced renal cell carcinoma (RCC) has been based on administration of cytokines. However, clinical efficacy of these immunomodulating-agents in general patients’ population was relatively low. The introduction of targeted agents has significantly changed the prognosis of advanced RCC patients. Inhibitors of multiple tyrosine kinases (mainly of VEGFR and PDGFR) are used as first (sunitinib, pazopanib) or second-line (pazopanib, sorafenib) treatment. Despite their evident clinical activity virtually all patients will develop resistance. The inevitable occurrence of resistance creates a challenge for oncologists associated with the choice of optimal next-line therapy that would make possible control of TKI-VEGFR-refractory RCC. Recently it has been demonstrated that axitinib, a second generation VEGFR-TKI inhibitor is active in RCC patients after sunitinib failure.
However, it is everolimus that remains the only agent currently approved for treatment of RCC refractory to multikinase inhibitors. In a phase III clinical study everolimus significantly prolonged progression free survival and time to deterioration of Karnofsky’s performance status, without significant negative influence on overall patients' quality of life.
Onkol. Prak. Klin. 2011; 7, 3: 113–118

Abstract

For many years treatment of advanced renal cell carcinoma (RCC) has been based on administration of cytokines. However, clinical efficacy of these immunomodulating-agents in general patients’ population was relatively low. The introduction of targeted agents has significantly changed the prognosis of advanced RCC patients. Inhibitors of multiple tyrosine kinases (mainly of VEGFR and PDGFR) are used as first (sunitinib, pazopanib) or second-line (pazopanib, sorafenib) treatment. Despite their evident clinical activity virtually all patients will develop resistance. The inevitable occurrence of resistance creates a challenge for oncologists associated with the choice of optimal next-line therapy that would make possible control of TKI-VEGFR-refractory RCC. Recently it has been demonstrated that axitinib, a second generation VEGFR-TKI inhibitor is active in RCC patients after sunitinib failure.
However, it is everolimus that remains the only agent currently approved for treatment of RCC refractory to multikinase inhibitors. In a phase III clinical study everolimus significantly prolonged progression free survival and time to deterioration of Karnofsky’s performance status, without significant negative influence on overall patients' quality of life.
Onkol. Prak. Klin. 2011; 7, 3: 113–118
Get Citation

Keywords

renal-cell carcinoma; advanced stage; second-line treatment; everolimus; molecular targeted therapy

About this article
Title

Renal-cell carcinoma — current options for the second-line treatment with specific focus on the role of everolimus

Journal

Oncology in Clinical Practice

Issue

Vol 7, No 3 (2011)

Article type

Review paper

Pages

113-118

Published online

2011-08-23

Bibliographic record

Onkol. Prak. Klin 2011;7(3):113-118.

Keywords

renal-cell carcinoma
advanced stage
second-line treatment
everolimus
molecular targeted therapy

Authors

Piotr J. Wysocki
Jakub Żołnierek
Krzysztof Krzemieniecki
Kazimierz Drosik
Piotr Potemski
Maciej Krzakowski

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