Possibilities of optimization of the second line targeted therapy for metastatic renal cell carcinoma

Optimization of treatment of metastatic renal cell carcinoma (mRCC) is an important problem of modern oncological urology. Targeted drugs replaced immunotherapy with cytokines and became the new standard of treatment. Their introduction resulted in increased patients» lifespan and fundamentally changed treatment of kidney cancer. Since 2005, 9 targeted drugs and 1 combination of lenvatinib and everolimus were registered and approved for treatment of mRCC. All of these drugs, except cabozantinib, are available in Russia. Currently, in mRCC treatment subsequent prescription of the drugs is used, i. e. patients receive several lines of targeted therapy. We still can»t name the most effective sequence of the 1st and 2nd lines of mRCC therapy due to a lack of clear algorithms of drug prescription. Currently, axitinib, cabozantinib,  everolimus, nivolumab, and sorafenib (in alphabetic order) and the combination of lenvatinib and everolimus are recommended for the 2nd line of mRCC therapy. However, there weren’t any direct comparative studies of their effectiveness, and therefore knowledge about differences between the targeted agents can make the selection more straightforward.

metastatic renal cell carcinoma, targeted therapy, second line, axitinib, nivolumab, everolimus, lenvatinib, progression-free survival