Until a few years ago, the treatment options for metastatic renal cell cancer (mRCC) were very limited.
The growing understanding of the molecular pathomechanisms underlying RCC allowed the development of new treatment approaches. Meanwhile, several approved target-oriented substances from different drug classes are available for mRCC. The mechanism of action of vascular endothelial growth factor (VEGF) and VEGF receptor or mTOR inhibition is well documented by phase III trials and reflected in the current guidelines. However, no predictive biomarkers have been identified in mRCC so far to demonstrate a benefit by a specific compound in an individual patient. Meanwhile, the sequential use of 'targeted therapies' in mRCC has been established as standard treatment. The optimal sequence of available agents is still unclear. A German RCC expert panel discussed and developed an algorithm for the choices of first- and second-line treatment in mRCC based on established clinical criteria.
Written by:
Bergmann L, Beck J, Bothe K, Brinkmann OA, Buse S, Goebell PJ, Grünwald V, Holzapfel K, Kübler H, Marschner NW, Mickisch G, Schultze-Seemann W, Siebels M, Siemer S, Störkel S, Gschwend JE. Are you the author?
Medizinische Klinik II, Universitätsklinik Frankfurt, Frankfurt am Main, Germany.
Reference: Oncol Res Treat. 2014;37(3):136-41.
doi: 10.1159/000360179
PubMed Abstract
PMID: 24685918
UroToday.com Renal Cancer Section