© 2007 European Society for Medical Oncology
symposium articles |
Treatment options in renal cell carcinoma: past, present and future
1 Hôpital Européen Georges Pompidou, Service de Cancérologie Médicale, Paris, France
2 Duke University Medical Center, Durham, NC
3 Memorial Sloan-Kettering Cancer Center, New York, NY, USA
* Correspondence to: S. Oudard, Hôpital Européen Georges Pompidou, Service de Cancérologie Médicale, 20, rue Leblanc 75908 Paris Cedex 15, France. Tel: +33-1-56-093-003; Fax: +33-1-56-092-803; E-mail: stephane.oudard{at}egp.aphp.fr
Cytokine therapies have been the standard of care in metastatic renal cell carcinoma (RCC). However, these agents only provide clinical benefit to a small subset of patients and are associated with significant toxicity. A better understanding of the molecular biology of RCC has identified the vascular endothelial growth factor (VEGF) and platelet-derived growth factor signalling pathways as rational targets for anticancer therapy. The multitargeted receptor tyrosine kinase inhibitors sunitinib and sorafenib have both demonstrated improved efficacy as second-line therapy in patients with RCC. Sunitinib has also been shown to be effective in the first-line setting, and has recently received European Union approval as first-line treatment for advanced and/or metastatic RCC. There is also recent evidence that temsirolimus (an inhibitor of the mammalian target of rapamycin) and bevacizumab (a mAb targeted against VEGF) may provide benefits in the first-line treatment setting. These results confirm that inhibiting these tumour targets is a feasible approach to treatment and provides a more positive outlook for the future management of metastatic RCC.
Key words: receptor tyrosine kinase inhibitor, renal cell carcinoma, sorafenib, sunitinib, temsirolimus