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Optimal management of metastatic renal cell carcinoma: an algorithm for treatment.

Bellmunt, Joaquim; Flodgren, Per LU ; Roigas, Jan and Oudard, Stéphane (2009) In BJU International1999-01-01+01:00 104. p.10-18
Abstract
The treatment of metastatic renal cell carcinoma (mRCC) has been changed by the introduction of targeted agents. Consideration of individual patient factors, such as previous treatment and prognostic risk, e.g. according to the Memorial Sloan-Kettering Cancer Center (MSKCC) risk criteria), can assist in ensuring that patients receive appropriate targeted therapies. Available clinical evidence shows sunitinib to be the reference standard of care for the first-line treatment of mRCC in patients at favourable or intermediate prognostic risk according to MSKCC criteria. Combined treatment with bevacizumab plus interferon-alpha can also be considered for the first-line treatment of mRCC in this setting. For the first-line treatment of poor-risk... (More)
The treatment of metastatic renal cell carcinoma (mRCC) has been changed by the introduction of targeted agents. Consideration of individual patient factors, such as previous treatment and prognostic risk, e.g. according to the Memorial Sloan-Kettering Cancer Center (MSKCC) risk criteria), can assist in ensuring that patients receive appropriate targeted therapies. Available clinical evidence shows sunitinib to be the reference standard of care for the first-line treatment of mRCC in patients at favourable or intermediate prognostic risk according to MSKCC criteria. Combined treatment with bevacizumab plus interferon-alpha can also be considered for the first-line treatment of mRCC in this setting. For the first-line treatment of poor-risk patients, temsirolimus has shown benefit in a phase III study, while sunitinib can also be considered. For second-line treatment in cytokine-refractory patients, sorafenib is recommended based on phase III trial results; sunitinib has also shown activity after failure of cytokine therapy or targeted agents. As well as antitumour activity, the tolerability of targeted agents should be evaluated in the context of individual patients, considering factors such as comorbidities and age. As our understanding of the activity of targeted agents for mRCC increases, we should ensure that these agents are used appropriately to provide patients with optimal treatment benefits. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BJU International1999-01-01+01:00
volume
104
pages
10 - 18
publisher
Blackwell Science Ltd
external identifiers
  • wos:000266874000004
  • pmid:19388982
  • scopus:67650506761
ISSN
1464-4096
DOI
10.1111/j.1464-410X.2009.08563.x
language
English
LU publication?
yes
id
88321d2b-b41f-4458-8b35-b01fd2b71d4f (old id 1391899)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19388982?dopt=Abstract
date added to LUP
2009-05-05 15:44:46
date last changed
2017-08-13 04:32:53
@article{88321d2b-b41f-4458-8b35-b01fd2b71d4f,
  abstract     = {The treatment of metastatic renal cell carcinoma (mRCC) has been changed by the introduction of targeted agents. Consideration of individual patient factors, such as previous treatment and prognostic risk, e.g. according to the Memorial Sloan-Kettering Cancer Center (MSKCC) risk criteria), can assist in ensuring that patients receive appropriate targeted therapies. Available clinical evidence shows sunitinib to be the reference standard of care for the first-line treatment of mRCC in patients at favourable or intermediate prognostic risk according to MSKCC criteria. Combined treatment with bevacizumab plus interferon-alpha can also be considered for the first-line treatment of mRCC in this setting. For the first-line treatment of poor-risk patients, temsirolimus has shown benefit in a phase III study, while sunitinib can also be considered. For second-line treatment in cytokine-refractory patients, sorafenib is recommended based on phase III trial results; sunitinib has also shown activity after failure of cytokine therapy or targeted agents. As well as antitumour activity, the tolerability of targeted agents should be evaluated in the context of individual patients, considering factors such as comorbidities and age. As our understanding of the activity of targeted agents for mRCC increases, we should ensure that these agents are used appropriately to provide patients with optimal treatment benefits.},
  author       = {Bellmunt, Joaquim and Flodgren, Per and Roigas, Jan and Oudard, Stéphane},
  issn         = {1464-4096},
  language     = {eng},
  pages        = {10--18},
  publisher    = {Blackwell Science Ltd},
  series       = {BJU International1999-01-01+01:00},
  title        = {Optimal management of metastatic renal cell carcinoma: an algorithm for treatment.},
  url          = {http://dx.doi.org/10.1111/j.1464-410X.2009.08563.x},
  volume       = {104},
  year         = {2009},
}