Current status of targeted therapy in metastatic renal cell carcinoma

Over the past few years, considerable advances in the understanding of the pathology and underlying molecular pathways in renal cell carcinoma (RCC) have been translated into the development of targeted therapeutics for this disease. Clear-cell RCC is characterised by the inactivation of the von Hippel-Lindau tumour suppressor gene, resulting in the dysregulation of hypoxia response genes, overproduction of vascular endothelial growth factor, Which promotes tumour angiogenesis, proliferation, and metastasis. Novel multitarget tyrosine kinase and angiogenesis inhibitors have achieved a benefit in progression-free and overall survival in patients with advanced RCC in recent prospective randomised trials. This review will describe the most relevant clinical data with the new molecular-targeted agents in RCC and provide an overview of current indications for these compounds. (c) 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved.