PMID- 19555586
OWN - NLM
STAT- MEDLINE
DCOM- 20090818
LR  - 20190917
IS  - 1540-1405 (Print)
IS  - 1540-1405 (Linking)
VI  - 7
IP  - 6
DP  - 2009 Jun
TI  - New treatments for renal cell carcinoma: targeted therapies.
PG  - 645-56
AB  - Systemic treatment options for advanced renal cell carcinoma (RCC) have expanded 
      considerably with the development of targeted therapies. Clear cell RCC commonly 
      features mutation or inactivation of the von Hippel-Lindau gene and resultant 
      overexpression of vascular endothelial growth factor (VEGF). The first drug to 
      validate VEGF as a target in the treatment of clear cell RCC was the monoclonal 
      antibody bevacizumab. Since then, anti-VEGF receptor therapy with multitargeted 
      kinase inhibitors also has shown substantial efficacy. Sunitinib is now a 
      standard first-line therapy for advanced disease and sorafenib is among the 
      second-line treatment options. Other kinase inhibitors are in development. 
      Mammalian target of rapamycin (mTOR) is a second validated therapeutic target as 
      the mTOR inhibitor temsirolimus has been shown to prolong survival in first-line 
      treatment of poor prognosis RCC of all histologies. Everolimus is an oral mTOR 
      inhibitor and has been shown to prolong progression-free survival when used in 
      second-line treatment. Non-clear cell and sarcomatoid RCC are both 
      underrepresented in completed trials but are the subject of active research. 
      Ongoing and planned studies will also evaluate the use of combinations of 
      targeted agents, a strategy that is not advisable outside of clinical trials. 
      Finally, postnephrectomy adjuvant treatment with targeted agents is not yet 
      standard but is under investigation in phase III trials.
FAU - Saylor, Philip J
AU  - Saylor PJ
AD  - Department of Oncology, Massachusetts General Hospital, Boston, Massachusetts 
      02114, USA. psaylor@partners.org
FAU - Michaelson, M Dror
AU  - Michaelson MD
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - J Natl Compr Canc Netw
JT  - Journal of the National Comprehensive Cancer Network : JNCCN
JID - 101162515
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Protein Kinase Inhibitors)
RN  - 2S9ZZM9Q9V (Bevacizumab)
RN  - EC 2.7.10.1 (EGFR protein, human)
RN  - EC 2.7.10.1 (ErbB Receptors)
SB  - IM
MH  - Antibodies, Monoclonal/therapeutic use
MH  - Antibodies, Monoclonal, Humanized
MH  - Bevacizumab
MH  - Carcinoma, Renal Cell/*drug therapy
MH  - *Drug Delivery Systems
MH  - ErbB Receptors/antagonists & inhibitors/therapeutic use
MH  - Humans
MH  - Kidney Neoplasms/*drug therapy
MH  - Protein Kinase Inhibitors/therapeutic use
RF  - 65
EDAT- 2009/06/27 09:00
MHDA- 2009/08/19 09:00
CRDT- 2009/06/27 09:00
PHST- 2009/02/04 00:00 [received]
PHST- 2009/04/22 00:00 [accepted]
PHST- 2009/06/27 09:00 [entrez]
PHST- 2009/06/27 09:00 [pubmed]
PHST- 2009/08/19 09:00 [medline]
AID - 10.6004/jnccn.2009.0045 [doi]
PST - ppublish
SO  - J Natl Compr Canc Netw. 2009 Jun;7(6):645-56. doi: 10.6004/jnccn.2009.0045.