Novel targeted therapy for advanced renal carcinoma: trials in progress.

Overview

PURPOSE OF REVIEW: Better understanding of renal cell carcinoma biology has led to a new era of targeted therapy in the management of metastatic renal cell carcinoma. This review provides an updated survey of the recently reported and ongoing clinical trials that will help to further define the role of these novel drugs in the treatment of renal cell carcinoma. RECENT FINDINGS: Treatment of metastatic renal cell carcinoma has dramatically changed in the past few years. Sunitinib, sorafenib, bevacizumab with interferon-alpha, pazopanib, temsirolimus, and everolimus have improved clinical outcomes in randomized phase III clinical trials by inhibiting vascular endothelial growth factors, other tyrosine kinases, the mammalian target of rapamycin pathway, and other related pathways. SUMMARY: Combinations and sequences of these agents are being evaluated. Other novel agents are in clinical development, some of which target novel pathways. Ongoing trials should help to define the exact role and timing of cytoreductive nephrectomy in metastatic or locally advanced renal cell carcinoma as well as the option for adjuvant treatments after surgery.