title: Tumour response in metastatic renal cell carcinoma treated with tyrosine kinase inhibitors - assessment of intra-tumour heterogeneity.
abstract: Intra-tumour heterogeneity is a common molecular phenomenon in metastatic clear cell renal carcinoma (mRCC), representing the genetic complexity of a tumour with multiple metastatic sites. The present commentary discusses the observed phenomena of phenotypic intra-tumour heterogeneity in mRCC patients treated with the tyrosine kinase inhibitors sunitinib or pazopanib. Here, drug response can be different on the level of each evaluated metastasis in the individual patient. This questions the currently used radiologic staging systems of RECIST criteria and demands for a modification of radiologic response assessment with the consequence of a patient-tailored therapy in the clinical setting.Please see related article: http://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-016-0729-9 .
authors.affiliation: Department of Urology, Eberhard Karls University, Hoppe-Seyler- Strasse 3, 72076, Tübingen, Germany.
authors.forename: Viktoria
authors.initials: V
authors.lastname: Stühler
authors.affiliation: Department of Urology, Eberhard Karls University, Hoppe-Seyler- Strasse 3, 72076, Tübingen, Germany. bedke@live.com.
authors.forename: Jens
authors.initials: J
authors.lastname: Bedke
mesh_terms: D000970:Antineoplastic Agents / Q000494:pharmacology; D002292:Carcinoma, Renal Cell / Q000188:drug therapy / Q000235:genetics / Q000473:pathology; D018740:Genetic Heterogeneity; D006801:Humans; D007191:Indazoles; D007211:Indoles / Q000494:pharmacology*; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000235:genetics / Q000473:pathology; D009362:Neoplasm Metastasis; D000071185:Pharmacogenomic Testing; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D011743:Pyrimidines / Q000494:pharmacology*; D011758:Pyrroles / Q000494:pharmacology*; D066066:Response Evaluation Criteria in Solid Tumors; D013449:Sulfonamides / Q000494:pharmacology*; D000077210:Sunitinib
chemical_list: D000970:Antineoplastic Agents; D007191:Indazoles; D007211:Indoles; D011743:Pyrimidines; D011758:Pyrroles; D013449:Sulfonamides; C516667:pazopanib; D011505:Protein-Tyrosine Kinases; D000077210:Sunitinib
keywords: Intra-tumour heterogeneity; Metastatic clear cell renal carcinoma; Pseudoprogression; RECIST criteria; Response pattern; Tyrosine kinase treatment