title: Systemic therapy for metastatic renal cell carcinoma: a review and update.
abstract: An in-depth understanding of metastatic renal cell carcinoma (mRCC) is important so that practitioners can make informed evidenced-based decisions with patients to optimize not only quantity of life but quality of life as well. Therefore, this review focuses on the biology of mRCC as it relates to targets for therapy, as well as on the small molecules rationally designed with these targets in mind. In addition, anticipated emerging therapies are highlighted, including the new tyrosine kinase inhibitors axitinib and tivozanib, as well as new immune-based therapies such as dendritic cell-based vaccines and antibodies. We also briefly review recent reports from the emerging field of predicting drug response based on molecular markers. And finally, management of metastatic non-clear cell RCC histologies are discussed focusing on available evidence to direct decision making when assessing therapeutic options.
authors.affiliation: Institute of Urologic Oncology, Department of Urology, The David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA.
authors.forename: Joshua E
authors.initials: JE
authors.lastname: Logan
authors.forename: Edward N
authors.initials: EN
authors.lastname: Rampersaud
authors.forename: Geoffrey A
authors.initials: GA
authors.lastname: Sonn
authors.forename: Karim
authors.initials: K
authors.lastname: Chamie
authors.forename: Arie S
authors.initials: AS
authors.lastname: Belldegrun
authors.forename: Allan J
authors.initials: AJ
authors.lastname: Pantuck
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Slamon
authors.forename: Fairooz F
authors.initials: FF
authors.lastname: Kabbinavar
keywords: Dendritic cell-based vaccines; Metastatic renal cell carcinoma; Non-clear cell renal cell carcinoma; Tyrosine kinase inhibitors