Sorafenib in the Management of Metastatic Renal Cell Carcinoma

[摘要] Until the advent targeted therapies, Interferon and Interleukin represented the standards of care for patients with metastatic renal cell carcinoma (mRCC). Over the past 2 years, five randomized placebo-controlled trials demonstrated the efficacy of five novel targeted therapies in mRCC patients.1-5First, Motzer et al. (n=750) showed that Sunitinib improves median progression free survival (PFS) in previously untreated patients, relative to Interferon, from 5 to 11 months (hazard ratio HR=0.42; p<0.001).1Escudier et al. (n=903) then showed in patients previously exposed to Interferon, relative to placebo, Sorafenib improves median PFS from 2.8 to 5.5 months (HR=0.51; p<0.001).2Subsequently, Hudes et al. (n=626) showed that in previously untreated patients, relative to Interferon, Temsirolimus improves median overall survival (OS) from 7.3 to 10.9 months (HR=0.73; p=0.0008).3Thereafter, Escudier et al. (n=649) showed that in previously untreated patients, relative to Interferon, Bevacizumab combined with Interferon improves median PFS from 5.4 to 10.2 months (HR 0.63; p=0.0001).4Most recently, Motzer et al. (n=410) showed that in patients who failed previous targeted therapies, relative to placebo, Everolimus improves median PFS from 1.8 to 4.6 months (HR=0.31; p<0.0001).5Taken together, these findings illustrate the efficacy of targeted therapies in first, second and subsequent treatment lines. In this manuscript, we will review data supporting the use of Sorafenib in first, second and subsequent lines. Moreover, we will show data that support the use of Sorafenib in patients with non-clear cell histology.Finally, we will present efficacy data for Sorafenib in dose escalation studies that demonstrate highly promising complete response rates (CR).

[学科分类] 肿瘤学