title: Anti-Angiogenic Drugs in the Treatment of Metastatic Renal Cell Carcinoma: Advances in Clinical Application.
abstract: The current paradigm in attempting to treat metastatic renal cell carcinoma (mRCC) is a first line treatment with a vascular endothelial growth factor (VEGF) antagonist and second and subsequent treatments with either a vascular endothelial growth factor receptor (VEGFR) or an mTOR (mammalian Target of Rapamycin) inhibitor, while conventional chemotherapeutic and hormonal treatments do not play a role in the management of mRCC. Several drugs directed against VEGF and VEGFR have been developed in recent times. Phase III data validates sunitinib, pazopanib and sorafenib as the best-supported drugs in firstline therapy. Second-line treatment possibilities include axitinib, everolimus and sorafenib. Choosing the right combination of first and second line treatments, however, is difficult, because the success of treatment depends on the precondition of the patient. Hence, biomarkers indicating the best choice of therapy in individual patients are searched and newer trials are set to determine the role of surgery and vaccination together with anti-angiogenic drugs in the treatment of mRCC. In this review, current guidelines in mRCC management are summarized and possibilities of future personalized therapies are pointed out.
authors.forename: Ole H
authors.initials: OH
authors.lastname: Nielsen
authors.affiliation: Institute of Biomedicine, Pharmacology, Aarhus University, Aarhus, Denmark, Wilhelm Meyers Allé 4, 8000 Aarhus C, Denmark. daniela.grimm@farm.au.dk.
authors.forename: Daniela
authors.initials: D
authors.lastname: Grimm
authors.forename: Markus
authors.initials: M
authors.lastname: Wehland
authors.forename: Johann
authors.initials: J
authors.lastname: Bauer
authors.forename: Nils E
authors.initials: NE
authors.lastname: Magnusson
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000818:Animals; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000556:secondary*; D009362:Neoplasm Metastasis; D040262:Receptors, Vascular Endothelial Growth Factor / Q000037:antagonists & inhibitors; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; D042461:Vascular Endothelial Growth Factor A; D040262:Receptors, Vascular Endothelial Growth Factor