Sequential use of targeted agents in the treatment of renal cell carcinoma

Hutson, Thomas E.; Bukowski, Ronald M.; Cowey, C. Lance; Figlin, Robert A.; Escudier, Bernard; Sternberg, Cora N.

doi:10.1016/j.critrevonc.2010.07.018

Cited by 53 publications

(46 citation statements)

References 72 publications

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“…[26] Despite the overlapping targets of TKIs, numerous studies have demonstrated the efficacy of sequential TKI therapies. [18,27,28] Similarly, mTOR-inhibitor usage following TKI therapy extends PFS compared with placebo in the second line. [24] 2.1 Post-VEGF inhibition: TKI and mTOR inhibitors Axitinib, which is a more specific and potent VEGF-TKI than sunitinib, sorafenib or pazopanib, is approved as a second-line treatment in many countries.…”

Section: Expert Opinionmentioning

confidence: 99%

Pharmacoeconomic and clinical implications of sequential therapy for metastatic renal cell carcinoma patients in Central and Eastern Europe

Vrdoljak

Torday

Szczylik

et al. 2015

Expert Opinion on Pharmacotherapy

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Introduction:The incidence and mortality rates of kidney cancer in the Central and Eastern European (CEE) region are among the highest in the world. Access to second and subsequent lines of metastatic renal cell carcinoma (mRCC) therapies is highly varied in the region. Despite the increasing body of evidence supporting the clinical benefit of multiple lines of treatment, access to treatment beyond first line is restricted in many of these countries. Areas covered: The adoption of targeted therapies for the first-line treatment of mRCC in the region was slow and faced many obstacles. In order to evaluate the current status of treatment beyond the first-line setting in the CEE region, this review examines the availability and reimbursement of mRCC drugs and clinical practice in institutions that treat patients with mRCC. Expert opinion: This review highlights the need to raise awareness among physicians, payers and regulators on clinical trial and cost-effectiveness data regarding the treatment of mRCC beyond the first line. The obstacles to mRCC drug access highlighted in this review need to be overcome to ensure that patients are receiving the best treatment available.

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Section: Expert Opinionmentioning

confidence: 99%

Pharmacoeconomic and clinical implications of sequential therapy for metastatic renal cell carcinoma patients in Central and Eastern Europe

Vrdoljak

Torday

Szczylik

et al. 2015

Expert Opinion on Pharmacotherapy

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“…In addition, when tumor responses occurred, they were remarkably durable, lasting on average approximately a year or more Escudier et al 2009;Sternberg et al 2010). Interestingly, antitumor activity has been reported in some patients who have progressed on one VEGF inhibitor when they are rechallenged with a different VEGF inhibitor (Medical News Today 2010; Hutson et al 2011). These findings raise important questions related to the mechanisms of resistance to anti-VEGF therapy, including whether those mechanisms can be reversed by a treatment interruption and/or by switching the inhibitor.…”

Section: Renal Cellmentioning

confidence: 97%

Anti-VEGF Therapies in the Clinic

Meadows

Hurwitz

2012

Cold Spring Harbor Perspectives in Medicine

201

123

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“…Downstaging may also decrease the risk of recurrence (10). Previous studies have demonstrated that targeted therapy may result in progression-free survival of ≤15 months and overall survival of ~26 months, and continuing therapy has resulted in overall survival of ≤4 years (19,20).…”

Section: Discussionmentioning

confidence: 99%

Presurgical neoadjuvant targeted molecular therapy for kidney cancer with concomitant vena cava tumor embolus: A clinical study

Guo¹,

Cai²,

Li³

et al. 2017

Oncology Letters

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Abstract. The present study aimed to investigate presurgical neoadjuvant targeted therapy for patients with kidney cancer and vena cava tumor embolus, in order to examine its indications, therapeutic effects and optimal timing of surgery. Between June 2009 and June 2014, 12 patients from The People's Liberation Army General Hospital (Beijing, China) were diagnosed with kidney cancer with superior vena cava tumor embolus, and received presurgical neoadjuvant targeted therapy (sorafenib 400 mg twice a day or sunitinib 50 mg/day) for a median of 13.3 weeks. Patients included 8 males and 4 females, with a median age of 49.8 years.Kidney cancer was present on the left side in 3 patients and in the right side in 9 patients. The median tumor embolus length was 9.7 cm (range, 6.5-14.0 cm). Tumor embolus levels II, III and IV, classified by the Mayo Clinic standard, were observed in 2, 6 and 4 patients, respectively. Median treatment time and average targeted therapy discontinuation time were observed to be longer in sunitinib-treated patients compared with sorafenib-treated patients. In total, 2 patients in the present study had partial remission (PR) and 8 patients had stable disease (SD); for tumor embolus, 4 patients had PR and 8 patients had SD. Tumor embolus length decreased by a median value of 18.7% (range, 0.0-42.1%) or 1.8 cm (range, 0.1-5.2 cm). Tumor diameter decreased by a median value of 8.6% (range, 0.0-38.9%) or 0.7 cm (range, 0.0-3.5 cm). The level of the tumor thrombus, classified by the Mayo Clinic standard, was observed to decrease following sunitinib treatment, including two cases downgraded from tumor thrombus level IV to II, one case from level IV to III and two cases from level III to II. Presurgical neoadjuvant targeted molecular therapy may have the potential to reduce the tumor stage of patients, as well as decreasing the surgical difficulty for radical nephrectomy.

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Sequential use of targeted agents in the treatment of renal cell carcinoma

Cited by 53 publications

References 72 publications

Pharmacoeconomic and clinical implications of sequential therapy for metastatic renal cell carcinoma patients in Central and Eastern Europe

Pharmacoeconomic and clinical implications of sequential therapy for metastatic renal cell carcinoma patients in Central and Eastern Europe

Anti-VEGF Therapies in the Clinic

Presurgical neoadjuvant targeted molecular therapy for kidney cancer with concomitant vena cava tumor embolus: A clinical study

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