Affiliation:
1. a Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France;
2. b Department of Pathology, Hôpital Saint Joseph, Paris, France
Abstract
AbstractNon-clear cell renal cell carcinomas (nccRCCs) comprise a heterogenous and poorly characterized group of tumor types for which few treatments have been approved. Although targeted therapies have become the cornerstones of systemic treatment for metastatic renal cell carcinoma, patients with nccRCC have been excluded from many pivotal clinical trials. As such, robust clinical evidence supporting the use of these agents in patients with nccRCC is lacking. Here, we review the disparate nccRCC subtypes, the criteria for diagnosis, and the prognoses associated with each subtype, in addition to evaluating the potential use of mammalian target of rapamycin (mTOR) inhibitors in treating patients with nccRCC. Both genetic analyses and preclinical research indicate a central role for mTOR in nccRCC; a therapy that targets this ubiquitous regulator of cellular signaling could prove efficacious across various tumor subtypes. Results from recent studies exploring targeted therapies as both monotherapy and combination therapy have provided early indications of efficacy in patients with nccRCC. Exploratory analyses support further research with the mTOR inhibitors everolimus and temsirolimus in patients with nccRCC. Current clinical practice guidelines support the use of mTOR inhibitors in patients with nccRCC; however, these recommendations are based on low levels of evidence. Further results from randomized, controlled clinical trials are needed to determine the optimal choice of therapy for patients with nccRCC. Results from ongoing clinical trials of mTOR inhibitors and other agents in nccRCC, as well as their impact on the nccRCC treatment paradigm, are eagerly awaited.
Funder
Novartis Pharmaceuticals Corporation
Publisher
Oxford University Press (OUP)
Reference56 articles.
1. Estimates of cancer incidence and mortality in Europe in 2008;Ferlay;Eur J Cancer,2010
2. Renal-cell carcinoma;Cohen;N Engl J Med,2005
3. Epidemiology and risk factors for kidney cancer;Chow;Nat Rev Urol,2010
4. Histopathological characteristics of adult renal tumours: A preliminary report;Latif;J Pak Med Assoc,2011
Cited by
15 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献