title: Emerging antiangiogenics for renal cancer.
abstract: BACKGROUND
  Antiangiogenic therapy is considered to be the backbone of treatment strategy in metastatic renal cell carcinoma (mRCC). New, more focused, targeted drugs are emerging, while other targeted drugs oriented toward resistance or alternative mechanisms are under development.
  
  
  METHODS
  Antiangiogenic agents include two types of agents: the monoclonal antibody, targeting vascular endothelial growth factor (VEGF), bevacizumab and the tyrosine kinase inhibitors (TKIs). Data regarding efficacy and safety of these agents are reported. Differences between the first generation of TKIs, sunitinib, sorafenib, and the new generation, pazopanib, axitinib and tivozanib are also detailed. Most of these agents have been approved in the treatment of kidney cancer in specific settings of the disease.
  
  
  CONCLUSIONS
  The class of antiangiogenic drugs for treatment of mRCC is already relatively full. After 'me-too' drugs, more targeted drugs against VEGFR have been developed but have to demonstrate a benefit in first-line treatment. Another option for the development is to combine a known drug with an antiangiogenic inhibition profile and at least one additional target involved in resistance to an antiangiogenic or in an alternative pathway. The cost of approach with targeted drugs, including antiangiogenics, has led to a tremendous increase in the cost of care in mRCC.
authors.affiliation: Bordeaux University Hospital, Hôpital Saint-André, Department of Medical Oncology , Bordeaux , France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Domblides
authors.forename: Marine
authors.initials: M
authors.lastname: Gross-Goupil
authors.forename: Amandine
authors.initials: A
authors.lastname: Quivy
authors.forename: Alain
authors.initials: A
authors.lastname: Ravaud
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000098:blood supply / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D018572:Disease-Free Survival; D055808:Drug Discovery; D019008:Drug Resistance, Neoplasm / Q000187:drug effects; D006801:Humans; D007680:Kidney Neoplasms / Q000098:blood supply / Q000188:drug therapy*; D058990:Molecular Targeted Therapy
chemical_list: D020533:Angiogenesis Inhibitors