Current and Emerging Therapeutic Targets for Metastatic Renal Cell Carcinoma
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Purpose of review
The treatment of advanced renal cell carcinoma has evolved dramatically over recent years. In this review, we will summarize current and emerging therapies based on molecular targets and provide insight into treatment strategy for metastatic renal cell carcinoma.
We have witnessed a paradigm shift in the therapeutic landscape as treatment was formerly reliant on cytokine-based agents which have now been replaced with therapies targeting angiogenesis, mammalian target of rapamycin pathways, and immune responses. These dramatic changes are primarily due to our improved understanding of the underlying mutations and molecular mechanisms leading to tumorigenesis and progression.
We now have targeted agents in the form of small-molecule tyrosine kinase inhibitors, monoclonal antibodies, and mTOR inhibitors. Moreover, immunotherapy-targeting checkpoints of T-lymphocyte activity has provided increased overall survival and a new class of agents with potential to radically change the treatment options. With these agents and their combination, durable responses are increasingly seen even though treatment resistance remains a huge challenge. New treatment strategies are rapidly developing and the therapeutic landscape is expected for further evolution.
KeywordsRenal cell carcinoma Targeted therapy Immunotherapy
renal cell carcinoma
tyrosine kinase inhibitor
metastatic renal cell carcinoma
vascular endothelial growth factor
platelet-derived growth factor
mammalian target of rapamycin
National Comprehensive Cancer Network
median progression free survival
mesenchymal epithelial transition
objective response rate
fibroblast growth factor receptor
non-small cell lung cancer
health-related quality of life
activin receptor-like kinase 1
KZ and SW contributed to the data collection, data analysis, and writing of the manuscript.
Compliance with Ethical Standards
Conflict of Interest
Kevin Zarrabi declares that he has no conflict of interest.
Shenhong Wu has served as a speaker for Exelixis, Novartis, and Pfizer.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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