title: New anti-angiogenic targeted therapy in advanced renal cell carcinoma (RCC): current status and future prospects.
abstract: OBJECTIVE
  To address the rationale for anti-angiogenic targeted therapies in advanced RCC.
  
  
  METHODS
  We reviewed the international recent literature, using Pubmed search.
  
  
  RESULTS
  RCC is genetically linked to factors regulating angiogenesis, in particular vascular endothelial growth factor (VEGF). Sunitinib is a multitarget receptor tyrosine-kinase (TK) inhibitor, acting on VEGF receptor (VEGFR) and platelet-derived growth factor receptors (PDGFR). Sorafenib is an oral multikinase inhibitor (VEGFR and PDGFR) showing also inhibitors effect on the Raf system. Phase I trials showed no life threatening toxicities relates to these agents. Phase II and phase III trials showed that these antiangiogenic agents are effective in the treatment of advanced RCC, mainly in cytokine refractory metastatic RCC. Survival benefits exist in particular when advanced RCC patients undergo cytoreductive nephrectomies before the initiation of the systemic therapy. To better use this kind of targeted therapy in advanced RCC, different points must be developed: the identification of clinical characteristic of RCC able to predict outcomes and responses to therapy; differences among different compounds; advantages of combination or sequential therapies.
  
  
  CONCLUSIONS
  Targeted therapy with Sunitinib and Sorafenib has been approved to FDA and is revolutioning how we clinically approach advanced RCC.
authors.affiliation: Department U Bracci, University Sapienza, Rome, Italy. sciarrajr@hotmail.com
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sciarra
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Gentile
authors.forename: Stefano
authors.initials: S
authors.lastname: Salciccia
authors.forename: Andrea
authors.initials: A
authors.lastname: Alfarone
authors.forename: Franco
authors.initials: F
authors.lastname: Di Silverio
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D007155:Immunologic Factors