PMID- 21789110
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20111110
LR  - 20211020
IS  - 1758-8340 (Print)
IS  - 1758-8359 (Electronic)
IS  - 1758-8340 (Linking)
VI  - 1
IP  - 1
DP  - 2009 Jul
TI  - Systemic therapy for advanced renal cell carcinoma.
PG  - 15-27
LID - 10.1177/1758834009338430 [doi]
AB  - Renal cell carcinoma (RCC) accounts for approximately 3% of all cancers and is 
      refractory to cytotoxic chemotherapy - immunotherapy has until recently been the 
      standard of care for advanced disease. Randomised trials reported in the last 5 
      years have demonstrated that a number of agents including the monoclonal 
      antibody, bevacizumab, and the kinase inhibitors - sorafenib sunitinib, 
      temsirolimus and everolimus - are active in advanced RCC. Bevacizumab is directed 
      against the vascular endothelial growth factor (VEGF), a key mediator of 
      angiogenesis, whilst sorafenib and sunitinib inhibit a number of targets 
      including the VEGF and platelet-derived growth factor (PDGFR) receptor tyrosine 
      kinases. Temsirolimus and everolimus inhibit the intracellular mammalian target 
      of rapamycin (mTOR) kinase. Sunitinib and temsirolimus have demonstrated efficacy 
      in comparison with immunotherapy in the first-line setting in patients with 
      favourable and poor prognosis advanced disease respectively. In the second-line 
      setting, everolimus has shown benefit over placebo in patients who progress 
      following treatment with a VEGF receptor tyrosine kinase inhibitor and sorafenib 
      has demonstrated efficacy in comparison with placebo in patients with 
      immunotherapy-refractory disease. We review here recent clinical trial data and 
      discuss future developments in the systemic treatment of RCC including 
      combination and sequential therapy, adjuvant therapy, the role of biomarkers and 
      the prospects for the development of rational mechanism-directed therapy in this 
      disease.
FAU - Larkin, James M G
AU  - Larkin JM
AD  - Department of Medicine, Royal Marsden Hospital, London SW3 6JJ, UK.
FAU - Kipps, Emma L S
AU  - Kipps EL
FAU - Powell, Ceri J
AU  - Powell CJ
FAU - Swanton, Charles
AU  - Swanton C
LA  - eng
PT  - Journal Article
PL  - England
TA  - Ther Adv Med Oncol
JT  - Therapeutic advances in medical oncology
JID - 101510808
PMC - PMC3125990
OTO - NOTNLM
OT  - bevacizumab
OT  - everolimus
OT  - renal cell carcinoma
OT  - sorafenib
OT  - sunitinib
OT  - temsirolimus
EDAT- 2009/07/01 00:00
MHDA- 2009/07/01 00:01
PMCR- 2009/07/01
CRDT- 2011/07/27 06:00
PHST- 2011/07/27 06:00 [entrez]
PHST- 2009/07/01 00:00 [pubmed]
PHST- 2009/07/01 00:01 [medline]
PHST- 2009/07/01 00:00 [pmc-release]
AID - 10.1177_1758834009338430 [pii]
AID - 10.1177/1758834009338430 [doi]
PST - ppublish
SO  - Ther Adv Med Oncol. 2009 Jul;1(1):15-27. doi: 10.1177/1758834009338430.