Calvani N*, Orlando L, Fedele P, Lutrino SE and Cinieri S
Medical Oncology Division and Breast Unit, A. Perrino Hospital, Brindisi, ItalyFulltext PDF
Treatment scenario of advanced renal cell carcinoma (RCC) has been characterized in the last decade by the approval of a number of new drugs. Choice of first line treatment falls essentially on sunitinib or pazopanib, two tyrosine kinase inhibitors (TKI), both exerting anti-tumor activity through inhibition of neoangiogenesis. In the second line setting, nivolumab, an immune checkpoint inhibitor antibody, has been shown to prolong overall survival (OS) vs. the mTOR inhibitor everolimus by restoring the adaptive anti-cancer immune response. Cabozantinib, a multi target TKI, may also get use in second line based on OS advantage vs. everolimus although toxicity appears substantial. The TKI axitinib remains still a viable option. Finally, combination therapy seems a very promising area and is under frenetic investigation in those patients progressing or refractory to angiogenesis inhibition as well as in first line setting.
Renal cell carcinoma; Nivolumab; Anti-PD-1 antibody; Cabozantinib; Tyrosine kinase inhibitor
Calvani N, Orlando L, Fedele P, Lutrino SE, Cinieri S. New Perspectives in the Treatment of Advanced Kidney Cancer. Clin Oncol. 2016; 1: 1031.