Optimizing treatment for metastatic renal cell carcinoma

Abstract

With the advent of targeted antiangiogenic therapies for renal cell carcinoma (RCC), the prognosis for patients with locally advanced or metastatic disease has significantly improved. Indeed, the results of several randomized clinical trials have demonstrated that targeted therapies, such as tyrosine kinase inhibitors (TKIs), provide superior efficacy and tolerability compared with traditional cytokine-based treatments. However, TKI therapy is still associated with significant toxicities related to off-target inhibition that are detrimental to patient quality of life. The results of ongoing head-to-head trials will determine how these agents compare with each other in terms of efficacy, and whether TKIs that interact with fewer off-target kinases have improved tolerability profiles. Furthermore, examining how these agents could be integrated with surgery to provide a multimodal approach to the treatment of metastatic RCC could further improve the outlook for RCC patients.

Keywords::

• neoadjuvant therapy
• renal cell carcinoma
• tyrosine kinase inhibitor
• vascular endothelial growth factor

Financial & competing interests disclosure

J-J Patard has been a consultant for Bayer, GlaxoSmithKline, IBA, Novartis and Pfizer, and has also received grant/research support from Pfizer. C Porta has been and advisor and speaker for Bayer, GlaxoSmithKline, Novartis, Pfizer, Roche and Wyeth, and has also received research funding from Bayer and Novartis. J Wagstaff has been a consultant for and has received honoraria from GlaxoSmithKline, Novartis, Pfizer and Roche. JE Gschwend has been a consultant for and has received honoraria from Bayer, GlaxoSmithKline, Novartis, Pfizer and Roche. This article was supported by an unrestricted educational grant from GlaxoSmithKline. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Editorial support for this article was provided by Medicus International, with funding from GlaxoSmithKline.