Treatment options in advanced renal cell carcinoma after first-line treatment with vascular endothelial growth factor receptor tyrosine kinase inhibitors

Abstract

Targeted therapy for metastatic renal cell carcinoma (mRCC) was introduced a decade ago and since then, a number of therapeutic options have been developed. Vascular endothelial growth factortargeted therapy is the widely accepted first-line option for mRCC. After progression, treatment in the second-line setting has typically been with either axitinib or everolimus. However, with the advent of several new agents demonstrating efficacy in the second-line setting, including nivolumab, cabozantinib, and the combination of lenvatinib and everolimus, the treatment paradigm has shifted toward these novel therapies with improved patient outcomes.

Sources of Frustration Among Patients Diagnosed With Renal Cell Carcinoma

“…With the rapid pace of therapeutic developments in RCC, several key milestones may have been missed. For instance, since June of 2017, several countries have issued approvals for second-line therapies such as nivolumab, cabozantinib and lenvatinib/everolimus (7, 18, 19). Adjuvant sunitinib was approved by the US FDA in November 2017, while EMA in February 2018 did not approve adjuvant sunitinib (8).…”