title: The Evolution of Systemic Therapy in Metastatic Renal Cell Carcinoma.
abstract: The treatment landscape for renal cell carcinoma (RCC) is a dynamic process that has seen considerable change in recent years. We have seen a rebirth of original breakthroughs with immune checkpoint inhibitors showing promise in patients with treatment-refractory disease. The optimal sequencing of treatments and incorporation of novel therapeutics are actively being investigated and have yet to be determined. The clinical challenges of this evolving treatment paradigm can be attributed to cost considerations, toxicity, and defining endpoints in the management of advanced RCC. As novel therapeutics emerge, finding the optimal treatment regimen for patients will have an increasing focus on patient-centered outcomes and improvement in quality of life in addition to improving survival.
authors.affiliation: From the Texas A&M Health Science Center, Bryan TX; Baylor-Sammons Cancer Center, Dallas, TX; US Oncology, Texas Oncology, Charles A. Sammons Cancer Center, Baylor University Medical Center, Dallas, TX; Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA; Cleveland Clinic Taussig Cancer Institute, Cleveland, OH.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Hutson
authors.affiliation: From the Texas A&M Health Science Center, Bryan TX; Baylor-Sammons Cancer Center, Dallas, TX; US Oncology, Texas Oncology, Charles A. Sammons Cancer Center, Baylor University Medical Center, Dallas, TX; Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA; Cleveland Clinic Taussig Cancer Institute, Cleveland, OH.
authors.forename: Gregory R
authors.initials: GR
authors.lastname: Thoreson
authors.affiliation: From the Texas A&M Health Science Center, Bryan TX; Baylor-Sammons Cancer Center, Dallas, TX; US Oncology, Texas Oncology, Charles A. Sammons Cancer Center, Baylor University Medical Center, Dallas, TX; Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA; Cleveland Clinic Taussig Cancer Institute, Cleveland, OH.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Figlin
authors.affiliation: From the Texas A&M Health Science Center, Bryan TX; Baylor-Sammons Cancer Center, Dallas, TX; US Oncology, Texas Oncology, Charles A. Sammons Cancer Center, Baylor University Medical Center, Dallas, TX; Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA; Cleveland Clinic Taussig Cancer Institute, Cleveland, OH.
authors.forename: Brian I
authors.initials: BI
authors.lastname: Rini
mesh_terms: D000813:Anilides / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000235:genetics / Q000276:immunology / Q000473:pathology; D059447:Cell Cycle Checkpoints / Q000187:drug effects / Q000276:immunology; D018572:Disease-Free Survival; D006801:Humans; D007376:Interleukin-2 / Q000235:genetics / Q000627:therapeutic use; D058990:Molecular Targeted Therapy; D009362:Neoplasm Metastasis; D010671:Phenylurea Compounds / Q000627:therapeutic use; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011725:Pyridines / Q000627:therapeutic use; D011804:Quinolines / Q000627:therapeutic use; D040262:Receptors, Vascular Endothelial Growth Factor / Q000037:antagonists & inhibitors / Q000235:genetics; D058570:TOR Serine-Threonine Kinases / Q000037:antagonists & inhibitors / Q000235:genetics*; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors / Q000235:genetics*
chemical_list: D000813:Anilides; D007376:Interleukin-2; D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors; D011725:Pyridines; D011804:Quinolines; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C558660:cabozantinib; C546842:MTOR protein, human; D040262:Receptors, Vascular Endothelial Growth Factor; D058570:TOR Serine-Threonine Kinases; C531958:lenvatinib