title: Immunologics and chemotherapeutics for renal cell carcinoma.
abstract: Treatment of metastatic renal cell carcinoma remains a challenge for clinicians. Traditional chemotherapy is ineffective and immunotherapy with interleukin-2 is only occasionally beneficial. The development of numerous agents targeting vascular endothelial growth factor and mammalian target of rapamycin signaling pathways that have been studied in phase III trials have resulted in significant improvement in survival for patients with clear cell renal cell carcinoma. Currently available U.S. Food and Drug Administration-approved first line targeted agents include sunitinib, pazopanib, temsirolimus, and bevacizumab (with interferon), while axitinib, everolimus, and sorafenib are most extensively used following progression as second- or third line therapy. Attempts to augment the activity of these agents by combining them together or with chemotherapy or immunotherapy have not yet proven to improve outcomes. As a result, the sequential use of single agents remains the current standard of care.
authors.affiliation: Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medical College.
authors.forename: Elan
authors.initials: E
authors.lastname: Diamond
authors.affiliation: Department of Medicine, St. Luke's-Roosevelt Hospital Center, New York, New York.
authors.forename: Jamie
authors.initials: J
authors.lastname: Riches
authors.affiliation: Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medical College.
authors.forename: Bishoy
authors.initials: B
authors.lastname: Faltas
authors.affiliation: Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medical College.
authors.forename: Scott T
authors.initials: ST
authors.lastname: Tagawa
authors.affiliation: Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medical College.
authors.forename: David M
authors.initials: DM
authors.lastname: Nanus
keywords: VGEF inhibitors; chemotherapy; interleukin-2; interventional radiology; mTOR inhibitors; renal cell carcinoma