New strategies in treatment of patients with metastatic renal cell carcinoma
Article published in Urologia Polska 2007/60/4.

authors

Jakub Żołnierek, Piotr Wysocki, Paweł Nurzyński: Klinika Onkologii Centralnego Szpitala Klinicznego MON, Wojskowy Instytut Medyczny w Warszawie
Zakład Immunologii Nowotworów, Katedra Biotechnologii Medycznej, Uniwersytet Medyczny, Wielkopolskie Centrum Onkologii w Poznaniu

keywords

kidney, renal cell cancer, targeted therapy, thyrosine kinase inhibitor, VEGF

summary

As renal cell carcinoma appears to be resistant to conventional treatment modalities there is a strong need for development of new drugs to be used in therapy of patients with this malingancy. Immunotherapy, typically based on subcutaneous injections of interferon alfa in Poland offers results far from satisfactory. Introduction of advanced techniques of molecular biology into the practice helped to establish the potent role of membrane receptors for growth factors, especially its component with activity of thyrosine kinases in growth, proliferation, invasion and forming of metastatic lesions. These molecules became therapeutic targets. Nowadays it seems thyrosine kinases inhibitors are drugs of choice. Cytokines remain alternative for new agents and targeted therapy is a basement of second line treatments for patients who failed to benefit from immunotherapy. The most investigated and advanced in clinical trials process are Nexavar (sorafenib, BAY 439006), Sutent (sunitinib, SU 011248), Torisel (temsirolimus, CCI 779) oraz Avastin (bevacizumab).

The first and the second have already been formally approved for treatment of patients with renal cell carcinoma. Torisel has only approval of American FDA and can not be used in European Union yet.

The article is a short review of literature with special attention paid to clinical data. As clear cell renal carcinoma is the most frequent histology of kidney cancer and most clinical trials protocols allowed recruitment of patients with such diagnosis, data provided below refers to clear cell type. To date no recommendation for treatment of patients with non-clear cell type exists.

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