Abstract: |
Metastatic renal cell carcinoma (RCC) has been characterized by a resistance to systemic chemotherapy and poor overall survival. Cytokine therapy, the mainstay of treatment, provides responses in a minority of patients. The discovery of the VHL tumor suppressor gene, hypoxia inducible factor-1α (HIF-1α), and their roles in the growth of RCC identified a pathway on which to direct targeted therapy. Vascular endothelial growth factor (VEGF) plays a central role in RCC and has been a focus of multiple agents in clinical trials. Small molecule tyrosine kinase inhibitors, monoclonal antibodies, and novel agents are all being studied. Phase II studies show promising activity of sunitinib, sorafenib, and bevacizumab, and early results of phase III studies demonstrate the role of these agents in metastatic RCC. © 2008 Humana Press. |