New view on advanced renal cancer targeted therapies efficacy – controversies Review article
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Abstract
During the last few years the strong progress on new therapies in advanced/metastatic renal cell carcinoma has been observed. It is mostly related to understanding of significant renal cell cancer molecular basics. Previously, the standard of care for patients with advanced disease was cytokine therapy, such as interleukin-2 (IL-2) or interferon alpha. The efficacy of cytokines therapy is limited and both drugs are associated with significant toxicity. New therapies, called targeted therapies, have been approved based on randomized clinical trials, in accordance with the american Food and Drug Administration agency and the European Medicines Agency directives. Targeted therapies include vascular endothelial growth factor receptor tyrosine kinase inhibitors (sorafenib, sunitinib, pazopanib), monoclonal vascular endothelial growth factor antibodies (bevacizumab) and seronine-threonine kinase mTOR inhibitors (temsirolimus, everolimus) (mTOR, mammalian target of rapamycin). Based on mentioned clinical trials the efficacy of targeted therapies was demonstrated first of all on the basis of significant progression free survival improvement. Until now the gold standard of oncology treatment efficacy was the overall survival. The controversies and most recent reports on mentioned above end points with reference to efficacy results of medications used in advanced/metastatic renal cell cancer treatment are presented in this review.
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Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
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