Small molecule targeted therapies for the second-line treatment for metastatic renal cell carcinoma: a systematic review and indirect comparison of safety and efficacy

@article{Dranitsaris2013SmallMT,
  title={Small molecule targeted therapies for the second-line treatment for metastatic renal cell carcinoma: a systematic review and indirect comparison of safety and efficacy},
  author={George Dranitsaris and Susanne Schmitz and Reuben James Broom},
  journal={Journal of Cancer Research and Clinical Oncology},
  year={2013},
  volume={139},
  pages={1917-1926}
}
AbstractBackground Patients with metastatic renal cell carcinoma (mRCC) and a good performance status typically receive an anti-vascular endothelial growth factor receptor (VEGFR) TKI (sunitinib or pazopanib) as initial therapy. Upon disease progression or intolerance, there are four orally administered agents approved in the second-line setting (including cytokine-refractory). However, head-to-head comparative trial data are limited. In this study, an indirect statistical comparison of safety… 
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TLDR
Patients with aRCC receiving axitinib as second targeted therapy were more likely to initiate at a higher than label-recommended dose and were morelikely to dose escalate than patients receiving everolimus, and drug costs were significantly higher—by 17% per month of PFS—with axit inib than with everolitus.
The need for new algorithms of treatment sequencing in clear-cell metastatic renal cell carcinoma
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All systemic therapeutic options currently available are reviewed, the evidence behind the current options available for mRCC patient treatment is described, and personal cues to support clinical decisions are provided.
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