title: Evolving therapeutic targets in renal cell carcinoma.
abstract: OBJECTIVE
  Recent developments in the treatment of advanced renal cell carcinoma (RCC) will be discussed, with emphasis on data published over the past year. The genetics and molecular biology of the various histologic subtypes of kidney cancer will be reviewed, as these subtle yet important genomic and metabolic alterations provide the opportunity for rational drug development and personalized treatment regimens.
  
  
  RESULTS
  Additional targeted agents continue to be added to the uro-oncologist's armamentarium in the fight against metastatic kidney cancer. Targeting the vascular endothelial growth factor and its receptor, or the mammalian target of rapamycin complex, remains the foundation of systemic treatment. In clear cell RCC, increased emphasis is being placed on target selectivity and affinity in a bid to diminish off-target toxicity without compromising efficacy. Combination strategies targeting multiple pathways simultaneously continue to be explored. Histology-specific protocols testing later generation and novel agents in nonclear cell RCC should be made a priority, as there is still not a single drug approved specifically for a nonclear cell indication.
  
  
  CONCLUSIONS
  The number of approved treatments for advanced RCC continues to grow, but additional work is needed to further delineate the optimal drug, combination of agents, or sequence best suited to each subtype of RCC.
authors: Section of Urologic Oncology, The Cancer Institute of New Jersey and UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
authors: Eric A
authors: EA
authors: Singer
authors: Gopal N
authors: GN
authors: Gupta
authors: Daniel
authors: D
authors: Marchalik
authors: Ramaprasad
authors: R
authors: Srinivasan
mesh_terms: D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000378:metabolism*; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000378:metabolism*; D058990:Molecular Targeted Therapy; D016032:Randomized Controlled Trials as Topic