Clinical development of mTor inhibitors for renal cancer

被引:45
作者
Ghidini, Michele [1 ]
Petrelli, Fausto [2 ]
Ghidini, Antonio [3 ]
Tomasello, Gianluca [1 ]
Hahne, Jens Claus [4 ]
Passalacqua, Rodolfo [1 ]
Barni, Sandro [2 ]
机构
[1] ASST Osped Cremona, Oncol Dept, Oncol Unit, Cremona, Italy
[2] ASST Bergamo Ovest, Oncol Dept, Oncol Unit, Treviglio, Italy
[3] Casa Cura Igea, Med Oncol, Milan, Italy
[4] Inst Canc Res, Div Mol Pathol, Lab Gastrointestinal Canc Biol & Genom, Sutton, Surrey, England
关键词
mTOR inhibitors; renal cell carcinoma; advanced disease; everolimus; temsirolimus; ADVANCED SOLID TUMORS; PHASE-I/II TRIAL; ENDOTHELIAL GROWTH-FACTOR; CELL CARCINOMA; MAMMALIAN TARGET; TYROSINE KINASE; HEMATOLOGIC TOXICITIES; 1ST-LINE THERAPY; INTERFERON-ALPHA; OPEN-LABEL;
D O I
10.1080/13543784.2017.1384813
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Introduction: Renal cell carcinoma (RCC) accounts for approximately 3% of adult malignancies and 90-95% of neoplasms arising from the kidney. In the last 10years, clinical trials have established multitargeted tyrosine kinase inhibitors (TKIs) as the standard first-line treatment in patients with metastatic disease. Multiple agents are now available for treatment in subsequent lines.The mammalian target of rapamycin (mTOR) inhibitors (e.g., everolimus alone or with lenvatinib) are among the most effective options.Areas covered: This paper provides a complete and updated overview on mTOR inhibitors for the treatment of advanced RCC. The authors revised the results of the most recent completed clinical trials and provided information about ongoing trials.Expert opinion: mTOR pathway still represents an important driver for RCC management. Combination of everolimus and lenvatinib is considered a category 1 choice with cabozantinib and nivolumab for subsequent therapy in metastatic RCC according to NCCN guidelines v2.2017. These three treatments (levantinib/everolimus, cabozantinib, and nivolumab) all resulted in a superior efficacy compared to everolimus alone. Moreover, mTOR inhibitors, and in particular temsirolimus for poor risk patients, are available choices for treatment in non-clear cell carcinomas together with TKIs.
引用
收藏
页码:1229 / 1237
页数:9
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