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- Title
Update in mRCC - first-line therapy.
- Authors
Stănculeanu, Dana Lucia; Zob, Daniela; Toma, Oana Cătălina; Mihăilă, Raluca Ioana
- Abstract
Metastatic renal cancer is an important field regarding targeted therapy in oncology. If until the early 1990s we were only talking about immunologic treatment with high doses of interleukin 2 and alpha-interferon, starting with 2005 and 2006, antiangiogenic therapy appeared in the therapeutic arsenal and two new molecules, sorafenib and sunitinib, were approved for use. R.J. Motzer's study of sunitinib versus interferon- alpha treatment of naïve patients with metastatic disease and the clear cell carcinoma histological subtype published in New England Journal of Medicine in 2007 resulted in a double progression-free survival (PFS) - over 11 months versus 5 months for sunitinib, with p<0.001, and a convenient toxicity profile. In 2007, bevacizumab was registered in the first line of treatment for the same group of patients, a monoclonal antibody with antiangiogenic effect, following the study of AVOREN and CALGB 90206 (median PFS 10.2 months vs. 5.4 months). In case of “poor risk” renal cancer, the phase III ARCC study established the role of the mTOR inhibitor for this category of patients with an overall survival of 10.9 months and a statistically significant PFS. In 2010, another antiangiogenic TKI inhibitor, pazopanib, was recorded due to VEG 105192 study results, with a 54% reduction in risk of progression or death compared with placebo and a significant increase in PFS in all subgroups of patients. Anticipating the EMA requirement, the COMPARZ study was initiated, a head-to-head non-inferiority study comparing this molecule with sunitinib, because the data showed similar results of the two molecules in terms of effectiveness and safety profile. The results of the registration studies for the two molecules, sunitinib and pazopanib, have been confirmed by real-world data, along with data from the extended access programs. The results of the International Mrcc database Consortium confirmed the clinical results for sunitinb and pazopanib. In conclusion, the treatment line for metastatic renal cancer has remained unchanged from 2010 until now.
- Subjects
CANCER treatment; RENAL cell carcinoma; METASTASIS
- Publication
Oncolog-Hematolog, 2017, Issue 39, p34
- ISSN
2066-8716
- Publication type
Article