Antitumor Effects of Sunitinib or Sorafenib in Patients With Metastatic Renal Cell Carcinoma Who Received Prior Antiangiogenic Therapy

Tamaskar, Ila; García, Jorge A.; Elson, Paul; Wood, Laura S.; Mekhail, Tarek; Dreicer, Robert; Rini, Brian I.; Bukowski, Ronald M.

doi:10.1016/j.juro.2007.08.127

Cited by 143 publications

(88 citation statements)

References 11 publications

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“…Few reports are available suggesting that patients may benefit from use of a targeted agent after progression. In a retrospective trial, 30 patients (93% clear cell carcinoma) receiving sunitinib or sorafenib after progression on prior antiangiogenic therapy (thalidomide, lenalidomide, bevacizumab, volociximab, AG13736, sorafenib, or sunitinib) were evaluated [46]. Overall, ten patients experienced a PR and median TTP was 10.4 months.…”

Section: Sequential Targeted Agentsmentioning

confidence: 99%

Treatment of metastatic renal cell carcinoma

Reeves

Liu

2009

Cancer Chemother Pharmacol

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PurposeTo review the treatment of metastatic renal cell carcinoma (RCC), including the use of new targeted therapies. MethodsA search of MEDLINE (1966 to August 2008 and American Society of Clinical Oncology Meeting abstracts (2005 to May 2008) was preformed using the search terms bevacizumab, everolimus, interferonalfa (IFN-α), interleukin-2 (IL-2), sorafenib, sunitinib, temsirolimus, and RCC. Articles most pertinent to the treatment of metastatic RCC are reviewed. ResultsThe treatment of metastatic RCC has undergone a paradigm shift over the past 5 years from biologic response modifiers to new targeted therapies. Historically, response rates for the biological response modifiers, aldesleukin (IL-2), and IFN-α were approximately 15%. Recently, three targeted agents, sorafenib, sunitinib, and temsirolimus have been approved for the treatment of RCC. Additionally, bevacizumab has been investigated and shown to increase progression free survival in RCC. IL-2 remains the only agent to induce complete, durable remissions; however, many patients are not eligible for this therapy. Newer agents (sorafenib, sunitinib, and temsirolimus) have shown to be superior to IFN-α or placebo and bevacizumab combined with IFN-α has shown activity when compared to IFN-α alone. Unlike IL-2, the greatest benefit obtained with targeted therapies is in achieving stable disease (SD). Despite their benefit, targeted therapies have never been compared with each other in clinical trials and choosing the most appropriate agent remains challenging. To date, the optimal sequence or combination of treatments has not been defined; however, everolimus has recently demonstrated activity in patients progressing on targeted therapy. ConclusionsIL-2 remains the most active regimen in inducing complete responses; however, its use is accompanied by substantial morbidity and is limited to those with a good performance status. Targeted therapies are also efficacious in the treatment of RCC, with the major benefit being induction of SD. Future research will better define the sequencing of therapies, as well as, explore the activity of novel combination regimens.

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Section: Sequential Targeted Agentsmentioning

confidence: 99%

Treatment of metastatic renal cell carcinoma

Reeves

Liu

2009

Cancer Chemother Pharmacol

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“…In patients with advanced or mRCC after sunitinib or sorafenib failure, options include switching to another TKI (e.g., from sunitinib to sorafenib or from sorafenib to sunitinib) based on emerging data showing activity with sequential therapy; 29,30 switching to INF, based on limited data but activity in previous phase II studies (CCO guideline in press); and switching to temsirolimus, based on a small body of retrospective and phase II data. 31 In patients with advanced or metastatic sarcomatoid or poorly differentiated RCC, options include sunitinib, based on prospective, nonrandomized data from the Expanded Access Program; 24 sorafenib, based on prospective, nonrandomized data from the ARCCS expanded access trial; 25,32 chemotherapy, based on phase II data using agents such as 5FU, gemcitabine, doxorubicin and combinations of these showing activity; 33 and temsirolimus, based on subgroup analysis in from the pivotal phase III trial in which these patients were eligible.…”

Section: Progression After First-line Therapymentioning

confidence: 99%

Management of kidney cancer: Canadian Kidney Cancer Forum Consensus Statement

Jewett¹,

Knox²,

Kollmannsberger³

2013

CUAJ

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“…This break could be able to determine a reacquired drug-sensitivity by clones become resistant to TKI. Nevertheless, at present the majority of data are from small and retrospective studies regarding selected patients (36,37,(56)(57)(58)(59)(60)(61).…”

Section: New Drugs and Sequencesmentioning

confidence: 99%