[Systemic therapy of metastatic renal cell carcinoma: from many options to the therapeutic strategy].
In the last 5 years the paradigms for the treatment of metastatic renal cell cancer have fundamentally changed. Until 2005 systemic therapy was limited to the immunomodulating cytokines interferon-alfa and interleukin-2, in recent years, however, tyrosine kinase inhibitors, mTor inhibitors and monoclonal antibodies have been established for this therapeutic situation. Without validated predictive biomarkers it is currently not possible to select patients who are likely to benefit from a certain therapy. Therefore, most current guidelines stratify the patients into risk groups according to the MSKCC risk score. The resulting treatment algorithm for first-line therapy is limited to these new drugs within all risk groups. Since approval for more tyrosine kinase inhibitors and mTOR inhibitors is currently awaited, the number of treatment options will expand further in the near future. The present paper reviews the present study data and aims to provide practical advice for the treatment of patients suffering from metastatic renal cell cancer.
Ringhoffer
M
M
Klinik für Innere Medizin III, Universitätsklinikum, Ulm, Deutschland. mark.ringhoffer@klinikum-karlsruhe.de
Rinnab
L
L
Küfer
R
R
Greiner
J
J
D000465:Algorithms; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000473:pathology; D018450:Disease Progression; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use; D007376:Interleukin-2 / Q000009:adverse effects / Q000627:therapeutic use; D047908:Intracellular Signaling Peptides and Proteins / Q000037:antagonists & inhibitors; D009367:Neoplasm Staging; D017410:Practice Guidelines as Topic; D017346:Protein Serine-Threonine Kinases / Q000037:antagonists & inhibitors; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D058570:TOR Serine-Threonine Kinases
D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D016898:Interferon-alpha; D007376:Interleukin-2; D047908:Intracellular Signaling Peptides and Proteins; C546842:MTOR protein, human; D011505:Protein-Tyrosine Kinases; D017346:Protein Serine-Threonine Kinases; D058570:TOR Serine-Threonine Kinases