Current algorithms and prognostic factors in the treatment of metastatic renal cell carcinoma Journal Article
| Authors: | Molina, A. M.; Motzer, R. J. |
| Article Title: | Current algorithms and prognostic factors in the treatment of metastatic renal cell carcinoma |
| Abstract: | Metastatic renal cell carcinoma (RCC) is highly resistant to chemotherapy but responds modestly to cytokine therapy. The prognosis for longterm survival is poor. Approximately 10% of patients who present with metastatic disease or relapse after nephrectomy are alive at 5 years. Identification of prognostic or predictive factors for individual patient outcomes is necessary in order to develop tailored treatments that reduce the risk of relapse and enhance the chance of successful management. The relationship between pretreatment clinical features and survival has been evaluated in studies leading to the creation of a Memorial Sloan-Kettering Cancer Center (MSKCC) risk model. Additionally, the cloning of the von Hippels-Lindau tumor suppressor gene, and the elucidation of its role in upregulating growth factors associated with angiogenesis, has provided insight into RCC biology and defined a series of targets for novel therapeutic agents. These targeted agents, including sunitinib, sorafenib, temsirolimus, everolimus, and bevacizumab plus interferon-α, have shown benefit in phase III trials in first-and second-line therapy. Analysis of the data from these trials and use of prognostic models have resulted in a new paradigm for the treatment of metastatic RCC. Herein, we review these targeted agents, the MSKCC risk model, and the new paradigm for treatment of metastatic RCC. |
| Keywords: | cancer survival; clinical trial; drug tolerability; fatigue; review; sorafenib; bevacizumab; erlotinib; sunitinib; cancer combination chemotherapy; cancer risk; diarrhea; drug efficacy; drug safety; hypertension; hypophosphatemia; side effect; antineoplastic agents; clinical trials as topic; alpha interferon; cancer patient; comparative study; interleukin 2; multiple cycle treatment; anemia; leukopenia; mucosa inflammation; nausea; stomatitis; thrombocytopenia; vomiting; risk factors; antineoplastic activity; continuous infusion; angiogenesis; algorithms; kidney carcinoma; kidney neoplasms; nephrectomy; temsirolimus; asthenia; hyperglycemia; pneumonia; rash; molecular cloning; maculopapular rash; carcinoma, renal cell; peripheral edema; targeted therapy; hypercholesterolemia; isotretinoin; hand foot syndrome; kidney metastasis; everolimus; proteinuria; nomogram; hyperlipidemia; von hippel lindau protein; hypertriglyceridemia |
| Journal Title: | Clinical Genitourinary Cancer |
| Volume: | 6 |
| Issue: | SUPPL. 1 |
| ISSN: | 1558-7673 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2008-12-01 |
| Start Page: | S7 |
| End Page: | S13 |
| Language: | English |
| DOI: | 10.3816/CGC.2008.s.002 |
| PUBMED: | 19891124 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 11" - "Export Date: 17 November 2011" - "Source: Scopus" |
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