PMID- 23076127
OWN - NLM
STAT- MEDLINE
DCOM- 20130117
LR  - 20121116
IS  - 1423-0232 (Electronic)
IS  - 0030-2414 (Linking)
VI  - 84
IP  - 1
DP  - 2013
TI  - New insights into the management of renal cell cancer.
PG  - 22-31
LID - 10.1159/000342962 [doi]
AB  - Kidney cancer is composed of several bio-histological entities. The most frequent 
      type, clear-cell carcinoma, is not homogenous regarding gene mutations or 
      transcriptomic profiles, but the biologic classifications are not yet mature. 
      Therefore, biologically driven strategies of treatment have not yet been 
      developed in the clinical setting. The choice of first-line agent currently 
      depends on the prognostic criteria published by Motzer et al. [J Clin Oncol 
      1999;17:2530-2540] and recently by Heng et al. [J Clin Oncol 2009;27:5794-5799], 
      with anti-vascular endothelial growth factor (VEGF) therapies for good- or 
      intermediate-prognosis groups and anti-mammalian target of rapamycin (mTOR) for 
      poor-risk patients. In the past years, biological changes leading to resistance 
      to targeted agents have been widely investigated. Discoveries resulted in the 
      development of second-generation VEGF receptor tyrosine kinase inhibitors, 
      characterized by an improved potency and selectivity. Besides, co-inhibition of 
      signalling pathways mediating resistance to anti-VEGF are being developed 
      targeting fibroblast growth factor and c-Met. Dual mTOR/phosphatidylinositol 
      3-kinase inhibitors have greater efficacy than rapalogs in preclinical models and 
      are being investigated in early clinical trials. In conclusion, the changing 
      landscape in the biology and treatment of kidney cancer offers new opportunities 
      for clinicians to treat patients, but, due to relatively high costs, the use of 
      targeted therapies will likely be strongly controlled by health authorities.
CI  - Copyright (c) 2012 S. Karger AG, Basel.
FAU - Pecuchet, Nicolas
AU  - Pecuchet N
AD  - Department of Medical Oncology, Hopital Europeen Georges Pompidou, Paris, France.
FAU - Fournier, Laure S
AU  - Fournier LS
FAU - Oudard, Stephane
AU  - Oudard S
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20121016
PL  - Switzerland
TA  - Oncology
JT  - Oncology
JID - 0135054
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Neoplasm Proteins)
SB  - IM
MH  - Antineoplastic Agents/*therapeutic use
MH  - Carcinoma, Renal Cell/*drug therapy/metabolism
MH  - Humans
MH  - Kidney Neoplasms/*drug therapy/metabolism
MH  - *Molecular Targeted Therapy
MH  - Neoplasm Proteins/*antagonists & inhibitors/metabolism
EDAT- 2012/10/19 06:00
MHDA- 2013/01/18 06:00
CRDT- 2012/10/19 06:00
PHST- 2012/05/31 00:00 [received]
PHST- 2012/08/27 00:00 [accepted]
PHST- 2012/10/19 06:00 [entrez]
PHST- 2012/10/19 06:00 [pubmed]
PHST- 2013/01/18 06:00 [medline]
AID - 000342962 [pii]
AID - 10.1159/000342962 [doi]
PST - ppublish
SO  - Oncology. 2013;84(1):22-31. doi: 10.1159/000342962. Epub 2012 Oct 16.