Advances in renal cell carcinoma treatment

Abstract

The treatment of advanced renal cell carcinoma has been completely changed by the development of new therapeutic modalities during the past 3 years. In this time period six targeted agents have been approved for the treatment of advanced or metastatic disease. Phase 3 data support the use of sunitinib, bevacizumab plus interferon-α and pazopanib for patients with low and intermediate risk of clear-cell renal cell carcinoma. In the pivotal study of temsirolimus a significant longer overall survival compared with interferon-α in high-risk disease including non-clear-cell histology was observed. Patients pretreated with cytokines will benefit from sorafenib and pazopanib while everolimus has been shown to increase significantly progression-free survival after previous anti-angiogenesis therapy. In addition to these phase 3 data-based recommendations, several other factors have to be considered for treatment selection, for example, side effect profile and patients' comorbidities. Currently, the sequential use of the available targeted drugs and adjuvant treatment are the subject of ongoing clinical trials. However, medical treatment of renal cell carcinoma remains palliative and surgery remains the only curative approach in patients with localized, locally advanced and limited metastatic disease.

STAT3 Signaling in Cancer: Small Molecule Intervention as Therapy?

“…In the decade since the initial clinical evaluation of Sorafenib, most of the clinical trials have been in vascularized tumors: metastatic renal cell carcinoma, grain tumors including malignant glioma, and non-small cell carcinoma [170,[175][176][177][178][179][180]. In renal cell carcinoma, Bevacizumab, the humanized anti-VEGF monoclonal antibody, plus IFN produced superior progression-free survival (PFS) and overall response rate (ORR) compared to IFN, but it also yielded a marked increase for the risk of serious side effects.…”

The relationship between renal cell carcinoma and nuclear retinoid/rexinoid receptors

“…In patients with a high risk of postoperative local or distant relapse or in patients with inoperable tumours or metastatic disease systemic treatment is indicated. The most common treatment modalities in systemic treatment include immunotherapy (cytokines interferon α and interleukin-2) and in particular preparations of targeted therapy that inhibit angiogenesis and have higher efficiency [24][25][26] .…”

Diagnostic and prognostic value of scavenger receptor class B type 1 in clear cell renal cell carcinoma

“…4 Besides, 25% of patients will still develop metastatic recurrence after surgical treatment. 5 Worse more, patients with metastasis have a poor prognosis, with a 5-year survival Diagnostic and prognostic value of scavenger receptor class B type 1 in clear cell renal cell carcinoma rate less than 15%. 3 Therefore, it is urgent to identify effective diagnostic and prognostic biomarkers in ccRCC.…”