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Vascular Endothelial Growth Factor-Targeted Therapy for the Treatment of Renal Cell Carcinoma

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Abstract

Vascular endothelial growth factor (VEGF)-targeted agents have rapidly been adopted into standard-of-care treatment for renal cell carcinoma (RCC). However, a substantial proportion of patients fail to respond to these agents or experience considerable toxicity. This article reviews the benefits and limitations of currently approved anti-VEGF agents in advanced and metastatic RCC, and the role for newly approved and developmental agents. Sunitinib and bevacizumab plus interferon (IFN)-α have demonstrated significant improvements in progression-free survival (PFS) compared with IFNα in treatment-naïve patients. A PFS benefit has also been shown with sorafenib versus placebo second-line to cytokine therapy. However, no anti-VEGF agent has shown a significant overall survival benefit. Anti-VEGF therapy is generally well tolerated, but a number of key adverse events, including dermatological, mucosal and constitutional symptoms, may limit treatment compliance and success. Pazopanib is a recently approved, highly selective anti-VEGF agent that shows benefit in PFS over IFNα, with low rates of treatment-related adverse events and, therefore, may be better tolerated than other currently approved agents. The advent of VEGF-targeted therapy for RCC has greatly improved prospects for patients with advanced or metastatic disease, but more efficacious agents are required that demonstrate a clear survival advantage. Ongoing trials evaluating novel anti-VEGF therapies could establish whether the increased potency and selectivity of these agents results in improved efficacy and tolerability in RCC patients, further improving their prognosis.

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Acknowledgements

This article was supported by an unrestricted educational grant from GlaxoSmithKline. Editorial support for this article by way of manuscript revision and finalising for submission was provided by Medicus International with funding from GlaxoSmithKline. Dr Albiges has no conflict of interest to disclose. Dr Escudier has received honoraria from Bayer, Hoffman LaRoche, Genentech, GlaxoSmithKline, Novartis and Wyeth.

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  1. Department of Medical Oncology, Institut Gustave Roussy, 39 Rue Camille Desmoulins, 94805, Villejuif, France

    Bernard Escudier & Laurence Albiges

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Correspondence to Bernard Escudier.

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Escudier, B., Albiges, L. Vascular Endothelial Growth Factor-Targeted Therapy for the Treatment of Renal Cell Carcinoma. Drugs 71, 1179–1191 (2011). https://doi.org/10.2165/11591410-000000000-00000

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