Do the Results of the New Trials Change the Standard Treatment of Metastatic Renal Cell Cancer?
Autor: | Dick Johan van Spronsen, Pieter H.M. De Mulder, Sasja F. Mulder |
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Rok vydání: | 2007 |
Předmět: |
Niacinamide
Sorafenib Cancer Research medicine.medical_specialty Indoles Lung Neoplasms Pyridines Angiogenesis Inhibitors Antineoplastic Agents Disease Drug Costs Interventional oncology [UMCN 1.5] Renal cell carcinoma Sunitinib medicine Humans Pyrroles Intensive care medicine Carcinoma Renal Cell Sirolimus Clinical Trials as Topic Cytokine Therapy business.industry Phenylurea Compounds Standard treatment Benzenesulfonates Hematology medicine.disease Long-Term Care Kidney Neoplasms Temsirolimus Surgery Survival Rate Clinical trial Oncology Cytokines business medicine.drug |
Zdroj: | Onkologie, 30, 260-4 Onkologie, 30, 5, pp. 260-4 |
ISSN: | 2296-5262 2296-5270 0378-584X |
DOI: | 10.1159/000101194 |
Popis: | Item does not contain fulltext With the emergence of novel angiogenesis inhibitors, we are moving to a new era for patients with metastasized renal cell carcinoma. Since the results achieved reflect more a modification of the natural course of the disease than a cure, past achievements should not be neglected. Low-risk patients with clear cell histology, especially those with pulmonary metastasis only, should still be offered cytokine therapy. For intermediate-risk patients sunitinib is the treatment of choice. For high-risk patients, temsirolimus has to date provided the most convincing data, its availability is however limited. Data with sorafenib and sunitinib in the high-risk group are still anecdotal. The toxicity profiles of these 2 drugs are different and might particularly relate to patients with known cardiovascular co-morbidity. No sufficient data are available regarding sequential use. After cytokine failure, sorafinib is the treatment of choice. Patients should preferably be treated within clinical trials to answer unaddressed questions. It is well known that the strict entry criteria used within the clinical studies were applied very flexibly when drugs have been approved. These aspects require a careful follow-up to ascertain optimal use and to prevent misuse. Finally, the costs of prolonged treatment will be enormous, and only meaningful survival advantages will convince the health authorities to make these new treatments available for all patients. |
Databáze: | OpenAIRE |
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