title: Optimizing further treatment choices in short- and long-term responders to first-line therapy for patients with advanced renal cell carcinoma.
abstract: Sequencing decisions in advanced renal cell carcinoma are likely to become more difficult when new targeted agents are approved for first and subsequent lines of therapy. Approximately 70% of patients benefit from targeted therapy before progression, of which 20% can be described as short-term responders (progression-free survival: <6 months) and 50% as long-term responders (progression-free survival: >6 months). The remaining 30% show either no response (20%) or are intolerant to treatment (10%). The challenge is to establish the optimal second-line agent for over 70% of patients who progress following initial response to a first-line tyrosine kinase inhibitor. As it is impossible to define the optimal second-line therapy for every patient, it is suggested that age and comorbidities of the patient, the sites of disease and the side effects of previous therapies be taken into account in order to optimize the use of different agents sequentially.
authors.affiliation: Department of Medical Oncology, Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G. Veneziani 1, 20133 Milan, Italy. giuseppe.procopio@istitutotumori.mi.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Procopio
authors.forename: Roberto
authors.initials: R
authors.lastname: Sabbatini
authors.forename: Camillo
authors.initials: C
authors.lastname: Porta
authors.forename: Elena
authors.initials: E
authors.lastname: Verzoni
authors.forename: Enzo
authors.initials: E
authors.lastname: Galligioni
authors.forename: Cinzia
authors.initials: C
authors.lastname: Ortega
mesh_terms: D000367:Age Factors; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000378:metabolism / Q000401:mortality; D018572:Disease-Free Survival; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000401:mortality; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
chemical_list: D047428:Protein Kinase Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A