Abstract
For patients with metastatic renal cell cancer (RCC), therapeutic options after cytokine failure are rather limited. There is a considerable need to identify new substances for systemic therapy. Due to upregulation after the loss of a functional von Hippel Lindau gene product, the vascular endothelial growth factor (VEGF) pathway is a promising target for a molecular based therapy. Over the last few years, therapeutic agents have been developed which inhibit this pathway at various levels. Here, we provide an overview of the molecular background and currently used drugs which have entered clinical trials in the setting of metastatic RCC disease. Until now, the results from early clinical trials are very promising, however, the best schedule, dosage, potential combination regimens, as well as long time efficacy, are still to be determined.
MeSH terms
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Angiogenesis Inhibitors / administration & dosage
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Antineoplastic Agents / administration & dosage
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Carcinoma, Renal Cell / diagnostic imaging
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Carcinoma, Renal Cell / drug therapy
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Carcinoma, Renal Cell / genetics*
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Cell Cycle / drug effects
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Clinical Trials as Topic
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Drug Delivery Systems
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Gene Expression Regulation, Neoplastic / drug effects
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Gene Expression Regulation, Neoplastic / physiology
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Humans
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Indoles / therapeutic use
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Kidney Neoplasms / diagnostic imaging
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Kidney Neoplasms / drug therapy
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Kidney Neoplasms / genetics*
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Protein Biosynthesis / genetics*
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Pyrroles / therapeutic use
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Receptor Protein-Tyrosine Kinases / antagonists & inhibitors
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Signal Transduction / drug effects
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Signal Transduction / genetics
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Sunitinib
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Tomography, X-Ray Computed
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Vascular Endothelial Growth Factor A / genetics*
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Von Hippel-Lindau Tumor Suppressor Protein / genetics
Substances
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Angiogenesis Inhibitors
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Antineoplastic Agents
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Indoles
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Pyrroles
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Vascular Endothelial Growth Factor A
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Von Hippel-Lindau Tumor Suppressor Protein
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Receptor Protein-Tyrosine Kinases
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VHL protein, human
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Sunitinib