PMID- 30158285
OWN - NLM
STAT- MEDLINE
DCOM- 20200603
LR  - 20231011
IS  - 1549-490X (Electronic)
IS  - 1083-7159 (Print)
IS  - 1083-7159 (Linking)
VI  - 24
IP  - 3
DP  - 2019 Mar
TI  - The Current and Evolving Landscape of First-Line Treatments for Advanced Renal 
      Cell Carcinoma.
PG  - 338-348
LID - 10.1634/theoncologist.2018-0267 [doi]
AB  - Agents targeting the vascular endothelial growth factor (VEGF) and its receptors 
      (VEGFRs), as well as the mammalian target of rapamycin (mTOR) and immune 
      checkpoint receptor programmed death 1 (PD-1) signaling pathway have improved 
      clinical outcomes for patients with advanced renal cell carcinoma (RCC). The 
      VEGFR tyrosine kinase inhibitors (TKIs) pazopanib and sunitinib are FDA-approved 
      first-line treatment options for advanced RCC; however, other treatment options 
      in this setting are available, including the recently approved combination of 
      nivolumab (anti-PD-1) and ipilimumab (anti-cytotoxic T-lymphocyte-associated 
      protein-4 [CTLA-4]) for patients with intermediate or poor risk. Unfortunately, 
      treatment guideline recommendations provide little guidance to aid first-line 
      treatment choice. In addition, several ongoing randomized phase III trials of 
      investigational first-line regimens may complicate the RCC treatment paradigm if 
      these agents gain approval. This article reviews clinical trial and real-world 
      evidence for currently approved and investigational first-line treatment regimens 
      for advanced RCC and provides clinical evidence to aid first-line treatment 
      selection. IMPLICATIONS FOR PRACTICE: Vascular endothelial growth factor receptor 
      tyrosine kinase inhibitors are approved by the U.S. Food and Drug Administration 
      as first-line treatment options for advanced renal cell carcinoma; however, the 
      treatment paradigm is rapidly evolving. The combination of nivolumab plus 
      ipilimumab was recently approved for intermediate- and poor-risk patients, and 
      other combination strategies and novel first-line agents will likely be 
      introduced soon.
CI  - (c) AlphaMed Press 2018.
FAU - Calvo, Emiliano
AU  - Calvo E
AD  - Centro Integral Oncologico Clara Campal and START Madrid, Madrid, Spain 
      emiliano.calvo@startmadrid.com.
FAU - Porta, Camillio
AU  - Porta C
AD  - Medical Oncology, I.R.C.C.S. San Matteo University Hospital Foundation, Pavia, 
      Italy.
FAU - Grunwald, Viktor
AU  - Grunwald V
AD  - Clinic for Hematology, Hemostaseology, Oncology & Stem Cell Transplantation, 
      Medical School of Hannover, Hannover, Germany.
FAU - Escudier, Bernard
AU  - Escudier B
AD  - Department of Medical Oncology, Gustave Roussy, Villejuif, France.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20180829
PL  - England
TA  - Oncologist
JT  - The oncologist
JID - 9607837
RN  - 0 (Protein Kinase Inhibitors)
SB  - IM
MH  - Carcinoma, Renal Cell/*therapy
MH  - Humans
MH  - Kidney Neoplasms/*therapy
MH  - Protein Kinase Inhibitors/pharmacology/*therapeutic use
PMC - PMC6519762
OTO - NOTNLM
OT  - Immune checkpoint inhibitors
OT  - Immunotherapy
OT  - Renal cell carcinoma
OT  - Targeted therapy
OT  - Tyrosine kinase inhibitors
COIS- Disclosures of potential conflicts of interest may be found at the end of this 
      article.
EDAT- 2018/08/31 06:00
MHDA- 2020/06/04 06:00
PMCR- 2020/03/01
CRDT- 2018/08/31 06:00
PHST- 2018/05/05 00:00 [received]
PHST- 2018/07/05 00:00 [accepted]
PHST- 2018/08/31 06:00 [pubmed]
PHST- 2020/06/04 06:00 [medline]
PHST- 2018/08/31 06:00 [entrez]
PHST- 2020/03/01 00:00 [pmc-release]
AID - theoncologist.2018-0267 [pii]
AID - ONCO12679 [pii]
AID - 10.1634/theoncologist.2018-0267 [doi]
PST - ppublish
SO  - Oncologist. 2019 Mar;24(3):338-348. doi: 10.1634/theoncologist.2018-0267. Epub 
      2018 Aug 29.