PMID- 22832091
OWN - NLM
STAT- MEDLINE
DCOM- 20130510
LR  - 20220311
IS  - 1532-1967 (Electronic)
IS  - 0305-7372 (Linking)
VI  - 39
IP  - 4
DP  - 2013 Jun
TI  - What is the optimal therapy for patients with metastatic renal cell carcinoma who 
      progress on an initial VEGFr-TKI?
PG  - 366-74
LID - S0305-7372(12)00144-2 [pii]
LID - 10.1016/j.ctrv.2012.06.010 [doi]
AB  - Sequential treatment with targeted therapies is the current standard of care for 
      patients with metastatic renal cell carcinoma (mRCC). Most patients are initially 
      treated with a first-line vascular endothelial growth factor receptor-tyrosine 
      kinase inhibitor (VEGFr-TKI), but will eventually develop resistance and 
      subsequent disease progression. Patients with mRCC whose disease progresses 
      during initial VEGFr-TKI therapy may continue treatment with a different 
      VEGFr-TKI or they may switch to treatment with a mammalian target of rapamycin 
      (mTOR) inhibitor which has a different mechanism of action. Based on positive 
      results of the phase III RECORD-1 trial, clinical guidelines in the United States 
      and Europe recommend use of everolimus, an mTOR inhibitor, in patients with 
      VEGFr-TKI-refractory mRCC. Positive results of the phase III AXIS trial led to 
      recent approval in the United States of the VEGFr-TKI axitinib for use in 
      patients with mRCC who failed one previous therapy. VEGFr-TKIs and mTOR 
      inhibitors have distinct clinical effects with differing safety profiles, but to 
      date, no head-to-head comparisons in the post-VEGFr-TKI second-line setting are 
      available. This review discusses multiple factors that should be considered when 
      selecting a second-line therapy for patients with VEGFr-TKI-refractory mRCC, 
      including evidence-based guidelines, efficacy, safety, patient profile, and 
      clinician familiarity with available agents.
CI  - Copyright (c) 2012 Elsevier Ltd. All rights reserved.
FAU - Calvo, Emiliano
AU  - Calvo E
AD  - Centro Integral Oncologico Clara Campal and START Madrid, Madrid, Spain. 
      emiliano.calvo@start.stoh.com
FAU - Ravaud, Alain
AU  - Ravaud A
FAU - Bellmunt, Joaquim
AU  - Bellmunt J
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20120723
PL  - Netherlands
TA  - Cancer Treat Rev
JT  - Cancer treatment reviews
JID - 7502030
RN  - 0 (Protein Kinase Inhibitors)
RN  - EC 2.7.1.1 (MTOR protein, human)
RN  - EC 2.7.10.1 (FLT1 protein, human)
RN  - EC 2.7.10.1 (Vascular Endothelial Growth Factor Receptor-1)
RN  - EC 2.7.11.1 (TOR Serine-Threonine Kinases)
SB  - IM
MH  - Carcinoma, Renal Cell/*drug therapy/enzymology
MH  - Drug Resistance, Neoplasm
MH  - Humans
MH  - Kidney Neoplasms/*drug therapy/enzymology
MH  - Molecular Targeted Therapy
MH  - Protein Kinase Inhibitors/*therapeutic use
MH  - Randomized Controlled Trials as Topic
MH  - TOR Serine-Threonine Kinases/antagonists & inhibitors
MH  - Vascular Endothelial Growth Factor Receptor-1/antagonists & inhibitors
EDAT- 2012/07/27 06:00
MHDA- 2013/05/11 06:00
CRDT- 2012/07/27 06:00
PHST- 2012/03/15 00:00 [received]
PHST- 2012/06/22 00:00 [revised]
PHST- 2012/06/25 00:00 [accepted]
PHST- 2012/07/27 06:00 [entrez]
PHST- 2012/07/27 06:00 [pubmed]
PHST- 2013/05/11 06:00 [medline]
AID - S0305-7372(12)00144-2 [pii]
AID - 10.1016/j.ctrv.2012.06.010 [doi]
PST - ppublish
SO  - Cancer Treat Rev. 2013 Jun;39(4):366-74. doi: 10.1016/j.ctrv.2012.06.010. Epub 
      2012 Jul 23.