Maximising the duration of disease control in metastatic renal cell carcinoma with targeted agents: an expert agreement.

Details

Serval ID
serval:BIB_E1736D587255
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Maximising the duration of disease control in metastatic renal cell carcinoma with targeted agents: an expert agreement.
Journal
Medical oncology
Author(s)
Porta C., Tortora G., Linassier C., Papazisis K., Awada A., Berthold D., Maroto J.P., Powles T., De Santis M.
ISSN
1559-131X (Electronic)
ISSN-L
1357-0560
Publication state
Published
Issued date
09/2012
Peer-reviewed
Oui
Volume
29
Number
3
Pages
1896-1907
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't WOS Document Type: Review
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Review
Publication Status: ppublish
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.

Keywords
Antineoplastic Agents/therapeutic use, Carcinoma, Renal Cell/drug therapy, Clinical Trials as Topic, Drug Delivery Systems, Humans, Kidney Neoplasms/drug therapy
Pubmed
Create date
25/10/2011 8:14
Last modification date
20/08/2019 16:05
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