Brian I. Rini, MD, a staff member in the Department of Solid Tumor Oncology at the Taussig Cancer Institute at Cleveland Clinic in Ohio, describes that there is a long ways to go in the progress of therapy for advanced RCC. He expresses that axitinib, a drug that he investigate in his AXIS 1032 phase III trial, represents the pinnacle of VEGF receptor therapy and he feels the VEGF inhibitor field may have reached the peak of its potency.

Dr. Rini says there is room for new drug development on the VEGF front as well as along other targets. Once axitinib is fully developed, it is likely that VEGF receptor inhibition will be maxed out and they will need to turn to other targets and other ways of giving the drug. Ideally, there will be better ways of selecting the patients who will have more response and less toxicity. Dr. Rini adds those points are investigational at present.