The Current and Evolving Landscape of First-Line Treatments for Advanced Renal Cell Carcinoma.
Immune checkpoint inhibitors
Immunotherapy
Renal cell carcinoma
Targeted therapy
Tyrosine kinase inhibitors
Journal
The oncologist
ISSN: 1549-490X
Titre abrégé: Oncologist
Pays: England
ID NLM: 9607837
Informations de publication
Date de publication:
03 2019
03 2019
Historique:
received:
05
05
2018
accepted:
05
07
2018
pubmed:
31
8
2018
medline:
4
6
2020
entrez:
31
8
2018
Statut:
ppublish
Résumé
Agents targeting the vascular endothelial growth factor (VEGF) and its receptors (VEGFRs), as well as the mammalian target of rapamycin (mTOR) and immune checkpoint receptor programmed death 1 (PD-1) signaling pathway have improved clinical outcomes for patients with advanced renal cell carcinoma (RCC). The VEGFR tyrosine kinase inhibitors (TKIs) pazopanib and sunitinib are FDA-approved first-line treatment options for advanced RCC; however, other treatment options in this setting are available, including the recently approved combination of nivolumab (anti-PD-1) and ipilimumab (anti-cytotoxic T-lymphocyte-associated protein-4 [CTLA-4]) for patients with intermediate or poor risk. Unfortunately, treatment guideline recommendations provide little guidance to aid first-line treatment choice. In addition, several ongoing randomized phase III trials of investigational first-line regimens may complicate the RCC treatment paradigm if these agents gain approval. This article reviews clinical trial and real-world evidence for currently approved and investigational first-line treatment regimens for advanced RCC and provides clinical evidence to aid first-line treatment selection. IMPLICATIONS FOR PRACTICE: Vascular endothelial growth factor receptor tyrosine kinase inhibitors are approved by the U.S. Food and Drug Administration as first-line treatment options for advanced renal cell carcinoma; however, the treatment paradigm is rapidly evolving. The combination of nivolumab plus ipilimumab was recently approved for intermediate- and poor-risk patients, and other combination strategies and novel first-line agents will likely be introduced soon.
Identifiants
pubmed: 30158285
pii: theoncologist.2018-0267
doi: 10.1634/theoncologist.2018-0267
pmc: PMC6519762
doi:
Substances chimiques
Protein Kinase Inhibitors
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
338-348Informations de copyright
© AlphaMed Press 2018.
Déclaration de conflit d'intérêts
Disclosures of potential conflicts of interest may be found at the end of this article.
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