Chapter 10 New Systemic Treatment Approaches for Metastatic Renal Cell Carcinoma

1. Introduction

2. Molecular pathogenesis

2.1. Clear- cell variants renal cell carcinoma

2.2. Non clear-cell variant

3. Systemic treatment of metastatic renal cell carcinoma

3.1. Small molecular tyrosine kinase inhibitors

3.1.1. Sunitinib

3.1.1.1. Sunitinib intermittent dosing

3.1.1.2. Sunitinib continuous dosing

3.1.2. Sorafenib

3.1.3. Pazopanib

3.1.4. Axitinib

3.2. Anti-VEGF

3.2.1. Bevacizumab

3.3. mTOR inhibitors

3.3.1. Temsirolimus

3.3.2. Everolimus

4. New agents in clinical development

4.1. Tivozanib

4.2. Dovitinib

4.3. Regorafenib

5. Combination therapy in metastatic RCC

5.1. VEGF-ligands or receptor inhibitors / mTOR plus immunotherapy combination

5.2. VEGF-ligands or receptor inhibitors / mTOR combination

6. Sequencing therapy in metastatic RCC

6.1. Anti-angiogenic therapy after immunotherapy

6.2. mTOR blockade after anti-angiogenic therapy

6.3. Serial anti-angiogenic agents

7. Systemic treatment for non-clear cell renal cell carcinoma

8. Side effects of targeted therapies used in renal cell carcinoma

8.1. Hyperension

8.1.1. Hypertension as a biomarker

8.2. Fatigue

8.2.1. Fatigue as a biomarker

8.3. Hand and foot syndrome as biomarker

8.4. Other biomarkers

9. Quality of life in patients with renal cell carcinoma receiving targeted

9.1. Therapy

10. Conclusion

Author details

References