PMID- 21428882
OWN - NLM
STAT- MEDLINE
DCOM- 20110818
LR  - 20211203
IS  - 1875-533X (Electronic)
IS  - 0929-8673 (Linking)
VI  - 18
IP  - 11
DP  - 2011
TI  - Targeted-therapy in advanced renal cell carcinoma.
PG  - 1651-7
AB  - Surgery has been the mainstay of renal cell carcinoma (RCC) treatment for 
      resectable tumours. In stages I-III disease, nephrectomy is the standard of care 
      and may be curative. Historically, patients presenting with stage IV disease may 
      achieve improved survival with debulking nephrectomy, which is commonly performed 
      prior to systemic therapy. The response rate of immunotherapy is low, with a 
      smaller percentage exhibiting complete remission upon treatment. Therefore, new 
      therapeutic approaches against metastatic RCC are necessary. Recently, molecular 
      mechanisms responsible for the proliferation of RCC have been identified, and 
      molecular targeted therapy has developed. Clear cell RCC commonly features 
      mutation or inactivation of the von Hippel- Lindau (VHL) gene and resultant 
      over-expression 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. Sunitinib is now a standard first-line therapy for advanced 
      disease and sorafenib is among the second-line treatment options. 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 (PFS) when used in 
      second-line treatment. This review describes recent advances in molecular 
      targeted therapy for metastatic RCC, focusing on chemical structure and mechanism 
      of action of VEGFR and mTOR inhibitors.
FAU - Pirrotta, M T
AU  - Pirrotta MT
AD  - Oncology Unit, San Giuseppe Hospital, Via Boccaccio 20, 50053 Empoli, Italy. 
      mtpirrotta@hotmail.com
FAU - Bernardeschi, P
AU  - Bernardeschi P
FAU - Fiorentini, G
AU  - Fiorentini G
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United Arab Emirates
TA  - Curr Med Chem
JT  - Current medicinal chemistry
JID - 9440157
RN  - 0 (Vascular Endothelial Growth Factor A)
RN  - EC 2.7.1.1 (MTOR protein, human)
RN  - EC 2.7.11.1 (TOR Serine-Threonine Kinases)
SB  - IM
MH  - Carcinoma, Renal Cell/*drug therapy/pathology
MH  - Humans
MH  - Molecular Targeted Therapy/*methods
MH  - Neoplasm Metastasis/drug therapy
MH  - TOR Serine-Threonine Kinases/antagonists & inhibitors
MH  - Vascular Endothelial Growth Factor A/antagonists & inhibitors
EDAT- 2011/03/25 06:00
MHDA- 2011/08/19 06:00
CRDT- 2011/03/25 06:00
PHST- 2010/12/21 00:00 [received]
PHST- 2011/03/18 00:00 [accepted]
PHST- 2011/03/25 06:00 [entrez]
PHST- 2011/03/25 06:00 [pubmed]
PHST- 2011/08/19 06:00 [medline]
AID - BSP/CMC/E-Pub/2011/ 111 [pii]
AID - 10.2174/092986711795471293 [doi]
PST - ppublish
SO  - Curr Med Chem. 2011;18(11):1651-7. doi: 10.2174/092986711795471293.