Vascular endothelial growth factor-targeted therapy for the treatment of adult metastatic Xp11.2 translocation renal cell carcinoma.

Background: Adult "translocation" renal cell carcinoma (RCC), bearing transcription factor E3 (TFE3) gene fusions at Xp11.2, is a recently recognized, unique entity for which prognosis and therapy remain poorly understood. In the current study, the authors investigated the effect of vascular endothelial growth factor (VEGF)-targeted therapy in this distinct subtype of RCC.

Prognostic and predictive biomarkers in renal cell carcinoma.

With the recent advances in targeted therapies, biomarkers in renal cell carcinoma (RCC) continue to be developed. Historically, information regarding prognosis has come from clinicopathologic variables, however in recent years much research has focused on the molecular basis of renal cell cancer. The discovery of reliable biomarkers in RCC could have an important impact on diagnosis, prognosis, and prediction of therapeutic benefit.

Clinical outcome in metastatic renal cell carcinoma patients after failure of initial vascular endothelial growth factor-targeted therapy.

Objectives: To characterize and evaluate the efficacy of second-line therapy in patients who had progressed on initial anti-vascular endothelial growth factor (VEGF) therapy.

Methods: Between 2005 and 2007, patients with mRCC who received second-line therapy after 1st-line VEGF-targeted therapy were identified across 7 cancer centers.

Results: A total of 645 mRCC patients received first-line VEGF-targeted therapy, of which 216 patients received second-line VEGF-targeted therapy (sunitinib, n = 93; sorafenib, n = 80; bevacizumab, n = 11; axitinib, n = 8) or mammalian target of rapamycin (mTOR)-inhibiting agents (temsirolimus, n = 21; everolimus, n = 3).

Sunitinib.

Sunitinib is an oral multikinase inhibitor that blocks the vascular endothelial growth factor receptor (VEGFR), platelet-derived growth factor receptor (PDGFR) alpha and beta, c-kit, and other receptors. These attributes have proven to be efficacious in the treatment of metastatic renal cell carcinoma (RCC) and unresectable gastrointestinal stromal tumors (GIST). Most side effects, including hypertension, hand-foot syndrome, and diarrhea are generally well manageable.

Targeted therapy for metastatic renal cell carcinoma: current treatment and future directions.

An understanding of vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTOR) pathways has greatly changed the way metastatic renal cell carcinoma (RCC) is treated. Based on available phase III randomized trials, anti-VEGF agents such as sunitinib, sorafenib, bevacizumab-based therapy, and mTOR-targeted agents such as temsirolimus and everolimus have been used in the treatment armamentarium for this disease. Now that agents directed against these pathways have largely replaced immunotherapy as the standard of care, new questions have emerged and are the subject of ongoing clinical trials.

Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted agents: results from a large, multicenter study.

Purpose: There are no robust data on prognostic factors for overall survival (OS) in patients with metastatic renal cell carcinoma (RCC) treated with vascular endothelial growth factor (VEGF) -targeted therapy.

Methods: Baseline characteristics and outcomes on 645 patients with anti-VEGF therapy-naïve metastatic RCC were collected from three US and four Canadian cancer centers. Cox proportional hazards regression, followed by bootstrap validation, was used to identify independent prognostic factors for OS.

Tolerance of sunitinib in dialyzed patients with metastatic renal cell carcinoma.

The use of sunitinib in dialysis patients is poorly described but is of clinical importance. We report 2 cases of patients receiving sunitinib for metastatic renal cell carcinoma while undergoing dialysis. The first patient is undergoing hemodialysis and, though responding to sunitinib, is having significant fatigue and hypertension.

Non-clear cell renal cancer: features and medical management.

The treatment of metastatic renal cell carcinoma (RCC) has changed dramatically with the introduction of targeted therapies against vascular endothelial growth factor and the mammalian target of rapamycin. Because patients with clear cell histology account for more than 80% of patients with RCC, little evidence is available on treating patients with non-clear cell histologies. Most clinical trials have excluded them from enrollment, except for a randomized study investigating temsirolimus.

A population-based study evaluating the impact of sunitinib on overall survival in the treatment of patients with metastatic renal cell cancer.

Background: Sunitinib has replaced interferon (IFN) as a first-line standard of care in the treatment of metastatic renal cell carcinoma (RCC). This study aimed to determine overall survival and to confirm effectiveness in a population that includes poor prognosis patients.

Methods: Data were collected on all patients identified by the BC Cancer Registry with metastatic RCC who were treated with IFN or sunitinib.

Anti-angiogenic targets in the treatment of advanced renal cell carcinoma.

Drugs that target the vascular endothelial growth factor (VEGF) and platelet derived growth factor (PDGF) pathways have revolutionized the treatment of patients with metastatic renal cell cancer (RCC). Patients with clear cell RCC often have mutations or silencing of the von Hippel Lindau gene leading to an accumulation of HIF 1 alpha. This allows growth factors such as VEGF and PDGF to be upregulated to promote angiogenesis and endothelial stabilization.

Metastatic sarcomatoid renal cell carcinoma treated with vascular endothelial growth factor-targeted therapy.

Purpose: Metastatic renal cell carcinoma (mRCC) with sarcomatoid differentiation is an aggressive disease that is associated with poor outcomes to chemotherapy or immunotherapy. The utility of vascular endothelial growth factor (VEGF)-targeted therapy in patients with this disease is unknown.

Patients And Methods: Patients who had mRCC with sarcomatoid features in the primary tumor and who were treated with VEGF-targeted therapy were retrospectively identified.

Prolonged complete responses and near-complete responses to sunitinib in metastatic renal cell carcinoma.

Sunitinib is a tyrosine kinase inhibitor with activity against vascular endothelial growth factor (VEGF) receptor and platelet-derived growth factor receptor recently approved by the FDA for the treatment of advanced renal cell carcinoma (RCC). Complete responses (CRs) to sunitinib have been documented in the literature. However, a detailed description and analysis of these patients is lacking.

Prednisone monotherapy in asymptomatic hormone refractory prostate cancer.

Background: Patients with advanced prostate cancer eventually cease to respond to hormonal therapy and thus progress to hormone refractory prostate cancer (HRPC). Prednisone has been used in this setting; however, limited data is available for this monotherapy in the asymptomatic HRPC population.

Objective: To evaluate the PSA response rate to prednisone in asymptomatic patients with hormone refractory prostate cancer (HRPC).