Abstract
Renal cell carcinoma is a highly vascular tumor associated with expression of vascular endothelial growth factor (VEGF). Recently, VEGF-targeted therapies have been identified as a promising therapeutic approach. Three agents targeting the VEGF pathway have shown clinical activity as monotherapy in metastatic renal cell carcinoma: the anti-VEGF monoclonal antibody, bevacizumab, and small-molecule VEGF receptor tyrosine kinase inhibitors, sorafenib and sunitinib. This article explores these agents in terms of their mechanisms of action, clinical efficacy, and toxicity profiles. This article also reviews future development strategies, including combination regimens and drug sequencing, trial design considerations, and patient selection opportunities.
MeSH terms
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Angiogenesis Inhibitors / pharmacology
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Antibodies, Monoclonal / adverse effects
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Antibodies, Monoclonal / pharmacology
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Antibodies, Monoclonal, Humanized
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Antineoplastic Agents / pharmacology*
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Benzenesulfonates / adverse effects
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Benzenesulfonates / pharmacology
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Bevacizumab
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Carcinoma, Renal Cell / blood supply
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Carcinoma, Renal Cell / drug therapy*
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Carcinoma, Renal Cell / metabolism*
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Clinical Trials as Topic
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Humans
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Indoles / adverse effects
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Indoles / pharmacology
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Kidney Neoplasms / blood supply
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Kidney Neoplasms / drug therapy*
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Kidney Neoplasms / metabolism*
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Neovascularization, Pathologic / drug therapy
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Neovascularization, Pathologic / metabolism
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Niacinamide / analogs & derivatives
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Phenylurea Compounds
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Protein Kinase Inhibitors / pharmacology
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Pyridines / adverse effects
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Pyridines / pharmacology
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Pyrroles / adverse effects
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Pyrroles / pharmacology
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Sorafenib
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Sunitinib
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Vascular Endothelial Growth Factor A / antagonists & inhibitors*
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Vascular Endothelial Growth Factor A / metabolism
Substances
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Angiogenesis Inhibitors
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Antibodies, Monoclonal
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Antibodies, Monoclonal, Humanized
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Antineoplastic Agents
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Benzenesulfonates
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Indoles
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Phenylurea Compounds
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Protein Kinase Inhibitors
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Pyridines
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Pyrroles
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Vascular Endothelial Growth Factor A
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Niacinamide
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Bevacizumab
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Sorafenib
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Sunitinib