title: An update on the medical therapy of advanced metastatic renal cell carcinoma.
abstract: The effectiveness of multikinase inhibitors in first- and second-line therapy of metastatic renal cell carcinoma (RCC) has been evaluated in various clinical studies. Initial results indicate an increased response rate and a prolonged progression-free survival compared with cytokine-containing therapeutic approaches. The new multitargeted kinase inhibitors sorafenib (Nexavar/BAY 43-9006) and sunitinib (Sutent/SUO 11248) interfere mainly with vascular endothelial growth factor and platelet-derived growth factor pathways. Recently, temsirolimus, a specific inhibitor of mammalian target of rapamycin, demonstrated activity in RCC patients with poor prognosis. This review discusses the effectiveness of the most frequently used substances for systemically progressive RCC in consideration of the currently available clinical data.
authors.affiliation: Department of Urology, Eberhard-Karls-University, Tuebingen, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Kruck
authors.forename: Axel S
authors.initials: AS
authors.lastname: Merseburger
authors.forename: Georgios
authors.initials: G
authors.lastname: Gakis
authors.forename: Mario W
authors.initials: MW
authors.lastname: Kramer
authors.forename: Arnulf
authors.initials: A
authors.lastname: Stenzl
authors.forename: Markus A
authors.initials: MA
authors.lastname: Kuczyk
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001557:Benzenesulfonates / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000556:secondary; D002986:Clinical Trials as Topic / Q000639:trends; D004359:Drug Therapy, Combination; D006801:Humans; D007211:Indoles / Q000627:therapeutic use; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011725:Pyridines / Q000627:therapeutic use; D011758:Pyrroles / Q000627:therapeutic use; D012720:Severity of Illness Index; D020123:Sirolimus / Q000031:analogs & derivatives / Q000627:therapeutic use; D000077157:Sorafenib; D000077210:Sunitinib; D016896:Treatment Outcome; D048490:raf Kinases
chemical_list: D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D007211:Indoles; D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors; D011725:Pyridines; D011758:Pyrroles; D009536:Niacinamide; C401859:temsirolimus; D000077157:Sorafenib; D048490:raf Kinases; D000077210:Sunitinib; D020123:Sirolimus