PMID- 20418207
OWN - NLM
STAT- MEDLINE
DCOM- 20100519
LR  - 20211203
IS  - 1769-6917 (Electronic)
IS  - 0007-4551 (Linking)
VI  - 97
DP  - 2010
TI  - [Advanced renal carcinomas with special situations. How to treat them?].
PG  - 83-90
LID - 10.1684/bdc.2010.1073 [doi]
AB  - Advanced or metastatic renal carcinoma represents a frequent disease in oncologic 
      practice. Few years ago, in immunotherapy era, treatments had quickly reached 
      deadlock. New therapies targeting vascular endothelial growth factors and their 
      receptors (VEGF-R), sorafenib, sunitinib and bevacizumab, and the mammalian 
      target of rapamycin (mTOR), temsirolimus and everolimus, have modified these 
      patients prognosis and their quality of life in a few years. Nevertheless, 
      patients included in randomized trials presented severe inclusion criteria. Then 
      in the daily practice, patients have distinctive characteristics which were not 
      evaluated in large pivotal studies: poor performance status, older patients, 
      renal dysfunction, cerebral metastases or non clear cell renal cancer. In 
      published trials, a few data concerning these situations are reported, and these 
      studies have often included small samples, were retrospective or not randomised. 
      However compared to global population, tolerance have not been very different in 
      geriatric patients, or patients with poor performance status, or with central 
      neurological metastases, or with papillary and chromophobe sub-types. On the 
      contrary progression free or overall survivals increases are more difficult to 
      confirm. Also before starting treatment, ratio between potential benefit and 
      possible toxicities have to be evaluated. In patients with renal insufficiency, 
      VEGF receptor inhibitors seem to be cautiously initiated at reduced doses, and to 
      be increased according to tolerance. Due to these poor proof levels, clinical 
      trials are needed for these specific populations.
FAU - Pouessel, D
AU  - Pouessel D
AD  - Hopital Henri-Mondor, Service d'oncologie medicale, 94010 Creteil cedex, France. 
      damien.pouessel@hmn.aphp.fr
FAU - Patard, J-J
AU  - Patard JJ
FAU - Culine, S
AU  - Culine S
LA  - fre
PT  - Journal Article
TT  - Cancers du rein avances en situations particulieres. Comment les traiter ?
PL  - France
TA  - Bull Cancer
JT  - Bulletin du cancer
JID - 0072416
RN  - 0 (Angiogenesis Inhibitors)
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Benzenesulfonates)
RN  - 0 (Indoles)
RN  - 0 (Intracellular Signaling Peptides and Proteins)
RN  - 0 (Phenylurea Compounds)
RN  - 0 (Pyridines)
RN  - 0 (Pyrroles)
RN  - 0 (Vascular Endothelial Growth Factor A)
RN  - 25X51I8RD4 (Niacinamide)
RN  - 2S9ZZM9Q9V (Bevacizumab)
RN  - 624KN6GM2T (temsirolimus)
RN  - 9HW64Q8G6G (Everolimus)
RN  - 9ZOQ3TZI87 (Sorafenib)
RN  - EC 2.7.1.1 (MTOR protein, human)
RN  - EC 2.7.10.1 (Receptors, Vascular Endothelial Growth Factor)
RN  - EC 2.7.11.1 (Protein Serine-Threonine Kinases)
RN  - EC 2.7.11.1 (TOR Serine-Threonine Kinases)
RN  - V99T50803M (Sunitinib)
RN  - W36ZG6FT64 (Sirolimus)
SB  - IM
MH  - Aged
MH  - Angiogenesis Inhibitors/*therapeutic use
MH  - Antibodies, Monoclonal/therapeutic use
MH  - Antibodies, Monoclonal, Humanized
MH  - Benzenesulfonates/therapeutic use
MH  - Bevacizumab
MH  - Brain Neoplasms/drug therapy/secondary
MH  - Carcinoma, Renal Cell/*drug therapy
MH  - Everolimus
MH  - Humans
MH  - Indoles/therapeutic use
MH  - Intracellular Signaling Peptides and Proteins/drug effects
MH  - Kidney Neoplasms/*drug therapy
MH  - Niacinamide/analogs & derivatives
MH  - Phenylurea Compounds
MH  - Protein Serine-Threonine Kinases/drug effects
MH  - Pyridines/therapeutic use
MH  - Pyrroles/therapeutic use
MH  - Receptors, Vascular Endothelial Growth Factor/drug effects
MH  - Sirolimus/analogs & derivatives/therapeutic use
MH  - Sorafenib
MH  - Sunitinib
MH  - TOR Serine-Threonine Kinases
MH  - Vascular Endothelial Growth Factor A/drug effects
EDAT- 2010/04/27 06:00
MHDA- 2010/05/21 06:00
CRDT- 2010/04/27 06:00
PHST- 2010/04/27 06:00 [entrez]
PHST- 2010/04/27 06:00 [pubmed]
PHST- 2010/05/21 06:00 [medline]
AID - bdc.2010.1073 [pii]
AID - 10.1684/bdc.2010.1073 [doi]
PST - ppublish
SO  - Bull Cancer. 2010;97:83-90. doi: 10.1684/bdc.2010.1073.