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Sequential use of targeted agents in the treatment of renal cell carcinoma

Sequential use of targeted agents in the treatment of renal cell carcinoma,10.1016/j.critrevonc.2010.07.018,Critical Reviews in Oncology Hematology,Th

Sequential use of targeted agents in the treatment of renal cell carcinoma   (Citations: 5)
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Sequential use of targeted therapies is a common practice in the treatment of advanced renal cell carcinoma (RCC) that extends disease control beyond the benefit of single therapies. After disease progression on one agent, treatment with a second targeted agent as subsequent-line therapy provides disease control and additional progression-free survival. The most effective sequence of targeted agents has yet to be determined. Results from the only trial of sequenced targeted agents support the use of mammalian target of rapamycin inhibitors after resistance develops to vascular endothelial growth factor (VEGF) inhibitors. Preliminary data suggest an antitumor effect of VEGF-targeted therapy in RCC, despite prior exposure to other VEGF-targeted therapies. The safety and efficacy of sequential therapies are currently under investigation; the optimal sequence may vary among patients to accommodate comorbid conditions or different disease stages. The current evidence supporting sequential use of targeted agents in RCC is presented in this review.
Journal: Critical Reviews in Oncology Hematology - CRIT REV ONCOL HEMATOL , vol. 77, no. 1, pp. 48-62, 2011
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    • ...The rationale for sequential therapy with mTOR inhibitors in rTKI refractory patients lies in the expectation that resistance of the tumor to rTKI treatment may be reversed by targeting a different signaling pathway [11,12]...

    Jonas Buschet al. Intrinsic resistance to tyrosine kinase inhibitors is associated with ...

    • ...In patients with metastatic clear cell RCC, targeted therapy leads to progression-free survival (PFS) of up to 15 months and an overall survival (OS) of 26 months, which may even reach 40 months with sequential therapy [5, 6]. However, most of these drugs were tested in trials in which non–clear cell histologies were excluded or underrepresented [7], except for one randomized study investigating temsirolimus [8•] and the expanded access ...

    Axel Bexet al. Non–Clear Cell Renal Cell Carcinoma: How New Biological Insight May Le...

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