title: Optimal treatment of poor-risk renal cell carcinoma patients with mTOR inhibitors and anti-VEGFR agents.
abstract: Poor-risk metastatic renal cell carcinoma (RCC) includes a subgroup of patients with unfavorable prognosis, according to both the Motzer and Heng criteria. Overall, owing to the poor prognosis of these patients, the approach is still a challenge for the first and subsequent lines of treatment, particularly for rare histologies other than clear cell renal cell carcinoma. In this review, we investigated the present treatment option of poor-risk metastatic RCC. Areas covered are data with first and further line of therapy with mTOR inhibitors and other agents but without cytoreductive nephrectomy or rare histologies. The current data on systemic therapy in poor-risk metastatic RCC maintain temsirolimus as the preferred first-line therapy. New agents targeting immune checkpoints are being developed in clinical trials.
authors.affiliation: a Oncology Department - Medical Oncology Unit , Azienda ospedaliera Treviglio , Treviglio , BG , Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Coinu
authors.affiliation: a Oncology Department - Medical Oncology Unit , Azienda ospedaliera Treviglio , Treviglio , BG , Italy.
authors.forename: Fausto
authors.initials: F
authors.lastname: Petrelli
authors.affiliation: a Oncology Department - Medical Oncology Unit , Azienda ospedaliera Treviglio , Treviglio , BG , Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Barni
mesh_terms: D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000473:pathology; D015195:Drug Design; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology; D058990:Molecular Targeted Therapy; D009362:Neoplasm Metastasis; D011379:Prognosis; D047428:Protein Kinase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D040262:Receptors, Vascular Endothelial Growth Factor / Q000037:antagonists & inhibitors; D012306:Risk; D058570:TOR Serine-Threonine Kinases / Q000037:antagonists & inhibitors
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; C546842:MTOR protein, human; D040262:Receptors, Vascular Endothelial Growth Factor; D058570:TOR Serine-Threonine Kinases
keywords: anti-VEGFR agents; mTOR inhibitors; poor-risk prognosis; renal cell carcinoma; targeted therapy