The Wide Experience of the Sequential Therapy for Patients with Metastatic Renal Cell Carcinoma.
Sequential targeted therapies are the standard of care for patients with metastatic renal cell carcinoma (mRCC). Several drugs are available for patients whose disease progresses while they receive initial tyrosine kinase inhibitor (TKI) therapy; these include nivolumab (an inhibitor of PD-1 receptor), everolimus (an inhibitor of the mechanistic target of rapamycin) or additional TKIs. Until now, there has been no clinical evidence to support the use of one strategy versus another, so investigators and physicians rely on experience, judgement and findings from molecular analyses to select the appropriate treatment. However, with the arrival of nivolumab and cabozantinib that provide an overall survival higher than other alternative treatments, therapeutic strategies may have changed. Here, we discuss findings from preclinical and clinical studies that might help clinicians to choose the optimal treatment approach for patients with mRCC who progress to initial therapy.
Hospital Clínico Universitario Lozano Blesa, Avenida San Juan Bosco, 15, 50009, Zaragoza, Spain. juliolambea@yahoo.es.
Julio
J
Lambea
Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain.
Urbano
U
Anido
Hospital Germans Trias I Pujol, Barcelona, Spain.
Olatz
O
Etxániz
Novartis Oncology, Barcelona, Spain.
Luis
L
Flores
Hospital Regional Universitario de Málaga, Málaga, Spain.
Álvaro
Á
Montesa
Hospital Universitario 12 de Octubre, Madrid, Spain.
Juan Manuel
JM
Sepúlveda
Hospital Universitario Central Asturias, Oviedo, Spain.
Emilio
E
Esteban
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000556:secondary*; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology
D000970:Antineoplastic Agents
Metastatic renal cell carcinoma; Sequential therapy; Targeted therapy; Tyrosine kinase inhibitor; VEGF; mTOR