title: Targeted therapy for cytokine-refractory metastatic renal cell carcinoma, and treatment in the community.
abstract: This report of a case of cytokine-refractory metastatic, clear-cell renal cell carcinoma (RCC) presents some current issues related to use of targeted therapy in the community. Due to the different mechanisms of cytostatic vs. cytotoxic agents, traditional response assessments may not always apply in deciding when to either continue or stop treatment. While community physicians may increasingly focus more on duration of response, symptom relief, and how well patients tolerate treatment, there is a clear need for validated surrogate markers of biologic activity and response, as well as randomized trials that directly compare some of the targeted therapies being applied in advanced RCC.
authors.affiliation: The Cleveland Clinic Foundation, Taussig Cancer Center, OH, USA. bukowsr@ccf.org
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Bukowski
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001557:Benzenesulfonates / Q000627:therapeutic use*; D015415:Biomarkers; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000473:pathology; D003153:Community Health Services; D016207:Cytokines / Q000187:drug effects*; D018450:Disease Progression; D016503:Drug Delivery Systems; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D011725:Pyridines / Q000627:therapeutic use*; D000077157:Sorafenib; D017211:Treatment Failure
chemical_list: D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D015415:Biomarkers; D016207:Cytokines; D010671:Phenylurea Compounds; D011725:Pyridines; D009536:Niacinamide; D000077157:Sorafenib