title: Sequencing systemic therapies in advanced RCC: is there a best strategy?
abstract: There is a strong rationale for sequencing targeted therapy in metastatic clear cell renal cancer. However the timing of the switch and the best agent to switch to remains unclear. Randomized data currently are supportive of the sequence of axitinib, followed by everolimus in those patients in which first-line vascular endothelial growth factor (VEGF) tyrosine kinase inhibitor (TKI) therapy fails. Everolimus is also justified in the second-line setting, and the overall survival data for sorafenib in VEGF TKI resistant disease is impressive. A degree of cross-resistance appears to exist between all these current agents and has resulted in a drive toward the development of new therapies with novel modes of action.
authors.affiliation: From the Barts Cancer Institute, St Bartholomew's Hospital, Queen Mary University of London, London, United Kingdom.
authors.forename: Tom
authors.initials: T
authors.lastname: Powles
authors.forename: Shanthini M
authors.initials: SM
authors.lastname: Crusz
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000037:antagonists & inhibitors / Q000235:genetics / Q000378:metabolism; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism / Q000401:mortality / Q000473:pathology; D018450:Disease Progression; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D057915:Drug Substitution; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism / Q000401:mortality / Q000473:pathology; D025202:Molecular Diagnostic Techniques; D058990:Molecular Targeted Therapy; D011237:Predictive Value of Tests; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage; D015398:Signal Transduction / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D014408:Biomarkers, Tumor; D047428:Protein Kinase Inhibitors