SEQUENTIAL TARGETED THERAPY FOR DISSEMINATED KIDNEY CANCER

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Abstract

Targeted therapy is a standard treatment in advanced renal cell carcinoma. Stabilization is an expected response to targeted therapy. The main goal of targeted therapy is to improve progression-free survival. This purpose is served through the sequential use of targeted agents. First-line therapy agents in the good and intermediate MSKCC prognostic groups are antiangiogenic ones such as bevacizumab, sunitinib, sorafenib, pazopanib; in the poor MSKCC prognostic group treatment of choice is an mTOR inhibitor temsirolimus. The antiangiogenic agent axitinib and the mTOR inhibitor everolimus were proved to be effective as second-line therapy. Axitinib administration after anti-VEGF drugs is associated with cumulative toxicity. The efficacy of axitinib in sorafenib-refractory renal cell carcinoma has not been proven. So everolimus remains the agent of choice for second-line targeted therapy. The effect of repeated antiangiogenic therapy may be anticipated after everolimus therapy.

 

About the authors

V. B. Matveev

N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, Moscow

Email: mivolkova@rambler.ru
Department of Urology Russian Federation

M. I. Volkova

N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, Moscow

Author for correspondence.
Email: mivolkova@rambler.ru
Department of Urology Russian Federation

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