Abstract
Advanced renal cell carcinoma is associated with a poor prognosis and is refractory to standard chemotherapy. Recent progress in the understanding of molecular biology and pathogenesis of renal cell cancer has been translated into the development of new therapeutic strategies. The management of metastatic RCC has been revolutionized with the development of targeted molecular therapies against VEGF-VEGFR and mTOR. Randomized phase III clinical trials demonstrated clinical benefit for patients with advanced RCC in overall survival and progression free survival. At the moment, six molecules have been approves in advanced RCC: cytokines (IL-2 and IFN), antiangiogenic therapies (sunitinib, sorafenib, bevacizumab) and mTOR inhibitors (Temsirolimus, everolimus). Nephrectomy is an important component of the multimodality treatment of mRCC. Prospective trials will be assessed the value of nephrectomy in patients treated by antiangiogenic therapies. Large randomized trial are ongoing to evaluate these new therapies in adjuvant setting.
MeSH terms
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Antibodies, Monoclonal / therapeutic use
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Antibodies, Monoclonal, Humanized
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Antineoplastic Agents / therapeutic use*
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Benzenesulfonates / therapeutic use
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Bevacizumab
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Carcinoma, Renal Cell / drug therapy*
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Carcinoma, Renal Cell / surgery
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Chemotherapy, Adjuvant
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Combined Modality Therapy
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Everolimus
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Humans
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Indoles / therapeutic use
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Interferons / therapeutic use
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Interleukin-2 / therapeutic use
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Intracellular Signaling Peptides and Proteins / antagonists & inhibitors
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Intracellular Signaling Peptides and Proteins / metabolism
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Kidney Neoplasms / drug therapy*
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Kidney Neoplasms / secondary
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Kidney Neoplasms / surgery
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Metabolic Networks and Pathways / drug effects
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Nephrectomy
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Niacinamide / analogs & derivatives
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Phenylurea Compounds
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Protein Serine-Threonine Kinases / antagonists & inhibitors
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Protein Serine-Threonine Kinases / metabolism
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Pyridines / therapeutic use
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Pyrroles / therapeutic use
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Sirolimus / analogs & derivatives
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Sirolimus / therapeutic use
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Sorafenib
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Sunitinib
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TOR Serine-Threonine Kinases
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Vascular Endothelial Growth Factor A / metabolism
Substances
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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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Interleukin-2
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Intracellular Signaling Peptides and Proteins
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Phenylurea Compounds
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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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temsirolimus
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Interferons
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Everolimus
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Sorafenib
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MTOR protein, human
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Protein Serine-Threonine Kinases
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TOR Serine-Threonine Kinases
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Sunitinib
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Sirolimus