Chemotherapy in metastatic renal cell carcinoma today? A systematic review

  title={Chemotherapy in metastatic renal cell carcinoma today? A systematic review},
  author={Sebastiano Buti and Melissa Bersanelli and Angelica Sikokis and Francesca Maines and Francesco Facchinetti and Emilio Bria and Andrea Ardizzoni and Giampaolo Tortora and Francesco Massari},
  journal={Anti-Cancer Drugs},
The prognosis of patients affected by metastatic renal cell carcinoma (mRCC) has improved markedly with targeted therapies. Unfortunately, 20–25% of the patients are refractory to treatment at the first response assessment and most patients will acquire drug resistance during the treatment. Moreover, current data on the clinical activity of targeted agents in poor risk or non-clear-cell mRCC patients are inconclusive because of the absence of prospective trials. Therefore, there are still… 
[Systemic Treatment of Metastatic Renal Cell Cancer--Back to the Future?].
The development of novel specific immunotherapeutic approaches now heralds the next level of treatment in mRCC, with the first significant trial results expected this year and further trials for optimisation of treatment warranted.
New treatment options for metastatic renal cell carcinoma with prior anti-angiogenesis therapy
This review provides an in-depth summary of drugs employable in the clinical setting, the rationale to their use, and the studies conducted leading to their approval for use and provides perspective on the paradigm shift in the treatment of renal cell carcinoma.
Immunomodulatory Activity of Nivolumab in Metastatic Renal Cell Carcinoma
Immunomodulatory effects of PD-1 inhibition were demonstrated through multiple lines of evidence across nivolumab doses in a hypothesis-generating prospective mRCC trial of previously treated patients with metastatic renal cell carcinoma.
Survival Outcomes and Tumor IMP3 Expression in Patients with Sarcomatoid Metastatic Renal Cell Carcinoma
None of the IHC markers predicted outcomes of treatment with VEGF or mTOR inhibitors, although only tumor IMP3 expression was associated with inferior OS, although not statistically significant.
Dose-finding/phase II trial: bevacizumab, immunotherapy, and chemotherapy (BIC) in metastatic renal cell cancer (mRCC). Antitumor effects and variations of circulating T regulatory cells (Treg)
There was a rapid increase in the percentage of Treg after immunotherapy and a reduction after bevacizumab only in patient who obtained a partial response or stable disease, and the BIC was feasible, well tolerated, and shown interesting activity.
Letter to the editor regarding: comparison of survival outcomes in patients with metastatic papillary vs. clear-cell renal cell carcinoma: a propensity-score analysis
This study included patients with primary pRCC or ccRCC but did not exclude multiple primary cancers, and ethnicity is unbalanced in Table 1 after propensity score matching, which is significant.
Comparative effectiveness of everolimus and axitinib as second targeted therapies for metastatic renal cell carcinoma in the US: a retrospective chart review
No significant differences were detected in OS or PFS between axitinib and everolimus as second targeted therapy and when stratifying by type and duration of first TKI, there was no statistically significant difference.
Role of dose exposure and inflammatory status in a single center, real-world analysis of sunitinib in patients with metastatic renal cell carcinoma.
Sunitinib is active and feasible and patients receiving <4 full-dose cycles or having increased neutrophil-lymphocyte ratio achieved worse outcomes: therefore, these are present potential predictive factors.
Pancreatectomy for metastatic renal cell carcinoma: twenty years of experience at a tertiary centre
This was the largest local study to describe an Australian experience of the surgical management of RCC pancreatic metastases, and patients are frequently afforded prolonged survival following pancreatic resection, but often develop other distant sites of disease and second renal tumours.
Cost-Effectiveness Analyses of Targeted Oral Anti-Cancer Drugs: A Systematic Review
Several types of cost-effectiveness studies remain under-represented in the literature on targeted OAMs, including those for follow-on indications approved after the initial indication for a drug and for off-label indications, head-to-head comparisons of targeted O AMs with other targeted Oams and targeted intravenous therapies, and studies that adopt a perspective other than the payer’s.


Chemotherapy in metastatic renal cell cancer
There is a great need to develop effective systemic therapy for advanced MRCC and to evaluate the efficacy of new drugs in clinical trials.
Phase II, Multicenter, Uncontrolled Trial of Single-agent Capecitabine in Patients With Non-clear Cell Metastatic Renal Cell Carcinoma
Cape citabine has clinical activity in MRCC patients who have non-clear cell histology and a good or intermediate prognosis and additional prospective randomized trial comparing capecitabine with placebo is required.
A phase II trial of pemetrexed in patients with metastatic renal cancer
Single-agent pemetrexed has moderate activity in the treatment of metastatic RCC and should be investigated in combination with other potential active agents, as first-line treatment.
IPM chemotherapy in cytokine refractory renal cell cancer
IMP produced symptomatic relief for a majority of patients with cytokine refractory RCC without any deterioration in QOL and disease stabilisation on radiological assessment and symptomatic improvement were associated with prolonged survival.
Chemoimmunotherapy with low dose vinorelbine and interleukin-2 in treatment of patients with metastatic renal cell carcinoma.
A phase II evaluation of a combination of vinorelbine and IL-2, both at low doses, in 30 patients with MRCC, finding the treatment feasible, with no renal, neurological or hematological toxicity.
Multicenter phase II trial of S-1 in patients with cytokine-refractory metastatic renal cell carcinoma.
  • S. NaitoM. Eto H. Akaza
  • Medicine, Biology
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2010
S-1 is active against cytokine-refractory mRCC and Quantification of TS mRNA levels in tumors before treatment may facilitate prediction of the response of mR CC to S-1.
Role of Chemotherapy With Gemcitabine Plus 5-fluorouracil and Chemoimmunotherapy in Metastatic Renal Cell Cancer (mRCC)
In these mRCC patients, both CT and chemoimmunotherapy showed modest but definite activity and a regimen CT-based should be offered to patients with progressive mR CC.
Capecitabine as third-line treatment in patients with metastatic renal cell carcinoma after failing immunotherapy
Capecitabine as third-line treatment showed a favourable toxicity profile, but exhibited low activity in patients with advanced renal cell carcinoma after failing immunotherapy.