Evolving landscape of the treatment of metastatic clear cell renal cell carcinoma

Clin Adv Hematol Oncol. 2018 Oct;16(10):677-686.

Abstract

The management of advanced clear cell renal cell carcinoma (RCC) has evolved over the past decade with the introduction of targeted therapies and immune checkpoint inhibitors. Recently, studies of dual checkpoint inhibition and of vascular endothelial growth factor (VEGF) inhibition combined with checkpoint inhibition have shown promising results, adding newer options to the treatment armamentarium for advanced RCC. Specifically, therapies combining checkpoint inhibitors of different classes and combining VEGF inhibitors with checkpoint inhibitors have gained much interest, and results from studies of several other combinations are awaited. These and previously approved treatments offer multiple options to patients with advanced RCC. In this review, we discuss the efficacy and safety results from the pivotal trials of these therapies, how the trial data can guide selection of the most appropriate therapy, and how to consider sequencing therapies in the care of patients with advanced RCC.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma, Clear Cell* / drug therapy
  • Adenocarcinoma, Clear Cell* / metabolism
  • Adenocarcinoma, Clear Cell* / pathology
  • Angiogenesis Inhibitors / therapeutic use*
  • Antineoplastic Agents / therapeutic use*
  • Humans
  • Kidney Neoplasms* / drug therapy
  • Kidney Neoplasms* / metabolism
  • Kidney Neoplasms* / pathology
  • Neoplasm Proteins / antagonists & inhibitors
  • Neoplasm Proteins / metabolism
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Vascular Endothelial Growth Factor A / metabolism

Substances

  • Angiogenesis Inhibitors
  • Antineoplastic Agents
  • Neoplasm Proteins
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A