Format

Send to:

Choose Destination
See comment in PubMed Commons below
Eur Urol. 2011 Oct;60(4):684-90. doi: 10.1016/j.eururo.2011.06.017. Epub 2011 Jun 24.

ICUD-EAU International Consultation on Kidney Cancer 2010: treatment of metastatic disease.

Author information

  • 1Department of Urology, Bicetre Hospital, Paris XI University, Le Kremlin Bicetre, France. jean-jacques.patard@live.fr

Abstract

CONTEXT:

Until the development of novel targeted agents directed against angiogenesis and tumour growth, few treatment options have been available for the treatment of metastatic renal-cell carcinoma (mRCC).

OBJECTIVE:

This review discusses current targeted therapies for mRCC and provides consensus statements regarding treatment algorithms.

EVIDENCE ACQUISITION:

Medical literature was retrieved from PubMed up to April 2011. Additional relevant articles and abstract reviews were included from the bibliographies of the retrieved literature.

EVIDENCE SYNTHESIS:

Targeted treatment for mRCC can be categorized for the following patient groups: previously untreated patients, those refractory to immunotherapy, and those refractory to vascular endothelial growth factor (VEGF)-targeted therapy. Sunitinib and bevacizumab combined with interferon alpha are generally considered first-line treatment options in patients with favourable or intermediate prognoses. Temsirolimus is considered a first-line treatment option for poor-risk patients. Either sorafenib or sunitinib may be valid second-line treatments for patients who have failed prior cytokine-based therapies. For patients refractory to treatment with VEGF-targeted therapy, everolimus is now recommended. Pazopanib is a new treatment option in the first- and second-line setting (after cytokine failure). Sequential and combination approaches, and the roles of nephrectomy and tumour metastasectomy will also be discussed.

CONCLUSIONS:

Increasing clinical evidence is clarifying appropriate first- and second-line treatments with targeted agents for patients with mRCC. Based on phase 2 and 3 trials, a sequential approach is most promising, while combination therapy is still investigational. The role of nephrectomy in mRCC is being evaluated in ongoing phase 3 clinical trials.

Copyright © 2011 European Association of Urology. Published by Elsevier B.V. All rights reserved.

PMID:
21704448
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Write to the Help Desk