title: Use of targeted therapies for advanced renal cell carcinoma in the Asia-Pacific region: opinion statement from China, Japan, Taiwan, Korea, and Australia.
abstract: Rates of renal cell carcinoma (RCC) morbidity and mortality vary widely by geography, with increasing incidence in most countries. Interestingly, RCC incidence is significantly lower in Asian countries relative to other regions, which is attributed to environmental and genetic influences. Additionally, it has been demonstrated that different ethnic groups differ in their RCC characteristics which might lead to varied responses to therapy. In this review, physicians drawn from countries across the Asia-Pacific region--China, Japan, Taiwan, Republic of Korea, and Australia--take all available data into consideration to develop the first opinion statement on treatment of advanced RCC in the region. We have sought to determine what factors influence treatment patterns and availability of therapeutic agents in our respective countries, discussed whether these factors are fully justified or should be modified, and considered what additional efforts should be undertaken to optimize treatment outcomes in RCC. Additionally, we have addressed the limitations on treatment of RCC in the region, capturing the restrictive situations of targeted therapy use in the Asia-Pacific region, mainly because of drug availability and treatment reimbursement. Often this illustrates the gap between Western and regional or even among local guidelines, the opinions of leading physicians regarding the treatment, and the realistic access to agents for most patients. Proposals made in this document are based on clinical experience and data from clinical trials of RCC therapies in which Asian patients have been included.
authors.affiliation: Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China. Electronic address: dwyeli@yahoo.com.cn.
authors.forename: Dingwei
authors.initials: D
authors.lastname: Ye
authors.affiliation: Department of Urology, Kumamoto University, Kumamoto, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Eto
authors.affiliation: National Cancer Center, Goyang-si Gyeonggi-do, Republic of Korea.
authors.forename: Jin Soo
authors.initials: JS
authors.lastname: Chung
authors.affiliation: Department of Urology, Nippon Medical School Hospital, Tokyo, Japan.
authors.forename: Go
authors.initials: G
authors.lastname: Kimura
authors.affiliation: Department of Hematology-Oncology, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Wen-Cheng
authors.initials: WC
authors.lastname: Chang
authors.affiliation: Department of Surgery, Division of Urology, Taipei-Veterans General Hospital, Taipei, Taiwan.
authors.forename: Yen-Hwa
authors.initials: YH
authors.lastname: Chang
authors.affiliation: Department of Surgery, Division of Urology, Chang Gung Memorial Hospital, TaoYuan, Taiwan.
authors.forename: See-Tong
authors.initials: ST
authors.lastname: Pang
authors.affiliation: Department of Oncology, Urologic Oncology Section, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Jae Lyun
authors.initials: JL
authors.lastname: Lee
authors.affiliation: The Second Hospital of Tianjin Medical Hospital, Tianjin, China.
authors.forename: Yuanjie
authors.initials: Y
authors.lastname: Niu
authors.affiliation: Australian School of Advanced Medicine, Macquarie University, New South Wales, Australia.
authors.forename: Howard
authors.initials: H
authors.lastname: Gurney
authors.affiliation: Department of Urology, Kinki University, Osaka, Japan.
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Uemura
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001315:Australia; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000378:metabolism; D002681:China; D005104:Expert Testimony; D006801:Humans; D007564:Japan; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D058990:Molecular Targeted Therapy; D009363:Neoplasm Proteins / Q000037:antagonists & inhibitors*; D011379:Prognosis; D056910:Republic of Korea; D013624:Taiwan
chemical_list: D000970:Antineoplastic Agents; D009363:Neoplasm Proteins
keywords: Clinical practice; Drug reimbursement; Metastatic renal cell carcinoma (mRCC); RCC guidelines; Tyrosine kinase inhibitor (TKI)