Robert A. Figlin, MD
The pharmacologic treatment for advanced renal cell carcinoma (RCC) has evolved considerably since the FDA approved interleukin-2 as the first systemic therapy for the tumor type in 1992.1
The next drug the agency approved was sorafenib (Nexavar), which was the first targeted therapy for RCC. Since then, the FDA has approved more than 20 drugs for RCC in the past 12 years. At a recent OncLive®
, a panel of experts in genitourinary malignancies talked about how the treatment paradigm for patients with advanced RCC has changed and is likely to continue changing.
“New data continue to emerge to help us navigate a pathway for each individual patient, often through multiple lines of therapy,” Figlin said. The basic goal of treatment remains the same: find a way to cure the patient’s cancer while preserving the quality of life. Panelist Eric Jonasch, MD, suggested progress is being made on that front, with the recent approval of immunooncology agents that prolong overall survival (OS) and even cure RCC in a subset of patients.
As the number of available drugs has grown, the patient population with RCC also has changed, Figlin observed. Toni K. Choueiri, MD, agreed and noted that they are now seeing a growing population of patients who had progression on multiple lines of therapy, including immunooncology drugs. Figlin expressed concern that some clinicians might be discontinuing traditional VEGF-targeted tyrosine kinase inhibitors (TKIs) too quickly—that instead of using dose adjustments to manage tolerance issues, there is a rush to switch patients to immuno-oncology drugs.
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