title: [Interdisciplinary Recommendations for the Treatment of Metastatic Renal Cell Carcinoma].
abstract: Thanks to the use of targeted therapies, the prognosis of patients with metastatic renal cell carcinoma (mRCC) has improved significantly. A median overall survival of more than 2 years is a realistic claim. These improvements are also reflected in recent discussions about 3 and more lines of therapy.Sunitinib, pazopanib, the combination of bevacizumab and interferon alpha, and temsirolimus are approved for first-line therapy of mRCC. Sunitinib and pazopanib are also approved for second-line therapy, which, for pazopanib, is confined to the use after cytokine failure. Everolimus (after tyrosine kinase inhibitor (TKI) treatment), sorafenib (after cytokines) and axitinib (after treatment with sunitinib or cytokines) are other compounds available for second-line therapy.3 new substances have recently been approved for second-line therapy: Nivolumab, cabozantinib, and lenvatinib combined with everolimus can be used after VEGF-targeted treatment has failed. It is for the first time that targeted immunotherapy and a combination of targeted substances are available for the treatment of mRCC.There is no new insight as to an optimal sequence therapy. Study results from a phase III trial suggest that the sequences sorafenib-sunitinib and sunitinib-sorafenib are equally effective.The purpose of an interdisciplinary expert meeting on RCC was to work out joint treatment recommendations based on current data and clinical experience and to integrate them into clinical routine practice. The results are presented in this publication.
authors.affiliation: Klinik für Urologie, Charité-Universitätsmedizin Berlin.
authors.forename: Kurt
authors.initials: K
authors.lastname: Miller
authors.affiliation: Medizinische Klinik II, J.W. Goethe-Universität Frankfurt/Main.
authors.forename: Lothar
authors.initials: L
authors.lastname: Bergmann
authors.affiliation: Urologikum Lübeck.
authors.forename: Christian
authors.initials: C
authors.lastname: Doehn
authors.affiliation: Klinik und Poliklinik für Urologie an der Technischen Universität München Klinikum rechts der Isar.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Gschwend
authors.affiliation: Charité-Med. Klinik III und Charité Comprehensive Cancer Center.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Keilholz
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D017326:Clinical Trials, Phase III as Topic; D004334:Drug Administration Schedule; D016503:Drug Delivery Systems; D006801:Humans; D033183:Interdisciplinary Communication; D000070516:Intersectoral Collaboration; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D009362:Neoplasm Metastasis / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D019233:Retreatment; D000077157:Sorafenib / Q000627:therapeutic use; D000077210:Sunitinib / Q000627:therapeutic use; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents; D000077157:Sorafenib; D000077210:Sunitinib