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Maximising the duration of disease control in metastatic renal cell carcinoma with targeted agents : an expert agreement
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Porta, C., Tortora, G., Linassier, C., Papazisis, K., Awada, A., Berthold, D., Maroto, J. P., Powles, T. and De Santis, Maria (2012) Maximising the duration of disease control in metastatic renal cell carcinoma with targeted agents : an expert agreement. Medical Oncology, Volume 29 (Number 3). pp. 1896-1907. doi:10.1007/s12032-011-0016-8 ISSN 1357-0560.
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Official URL: http://dx.doi.org/10.1007/s12032-011-0016-8
Abstract
With six targeted agents approved (sorafenib, sunitinib, temsirolimus, bevacizumab [+interferon], everolimus and pazopanib), many patients with metastatic renal cell carcinoma (mRCC) will receive multiple therapies. However, the optimum sequencing approach has not been defined. A group of European experts reviewed available data and shared their clinical experience to compile an expert agreement on the sequential use of targeted agents in mRCC. To date, there are few prospective studies of sequential therapy. The mammalian target of rapamycin (mTOR) inhibitor everolimus was approved for use in patients who failed treatment with inhibitors of vascular endothelial growth factor (VEGF) and VEGF receptors (VEGFR) based on the results from a Phase III placebo-controlled study; however, until then, the only licensed agents across the spectrum of mRCC were VEGF(R) inhibitors (sorafenib, sunitinib and bevacizumab + interferon), and as such, a large body of evidence has accumulated regarding their use in sequence. Data show that sequential use of VEGF(R) inhibitors may be an effective treatment strategy to achieve prolonged clinical benefit. The optimal place of each targeted agent in the treatment sequence is still unclear, and data from large prospective studies are needed. The Phase III AXIS study of second-line sorafenib vs. axitinib (including post-VEGF(R) inhibitors) has completed, but the data are not yet published; other ongoing studies include the Phase III SWITCH study of sorafenib–sunitinib vs. sunitinib–sorafenib (NCT00732914); the Phase III 404 study of temsirolimus vs. sorafenib post-sunitinib (NCT00474786) and the Phase II RECORD 3 study of sunitinib–everolimus vs. everolimus–sunitinib (NCT00903175). Until additional data are available, consideration of patient response and tolerability to treatment may facilitate current decision-making regarding when to switch and which treatment to switch to in real-life clinical practice.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Cancer Research Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Medical Oncology | ||||
Publisher: | Springer | ||||
ISSN: | 1357-0560 | ||||
Official Date: | September 2012 | ||||
Dates: |
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Volume: | Volume 29 | ||||
Number: | Number 3 | ||||
Page Range: | pp. 1896-1907 | ||||
DOI: | 10.1007/s12032-011-0016-8 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access |
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