Dosing strategies and optimization of targeted therapy in advanced renal cell carcinoma

    Research output: Contribution to journalReview article

    3 Citations (Scopus)

    Abstract

    Within the past decade, treatment options for metastatic renal cell carcinoma have expanded dramatically. Currently, seven targeted agents are approved for use in metastatic renal cell carcinoma and have superseded the use of parenteral cytokine therapy with interleukin-2 or interferon, the former standards of care for metastatic renal cell carcinoma. Targeted agents include inhibitors of the vascular endothelial growth factor pathway (i.e. sorafenib, sunitinib, pazopanib, axitinib, and bevacizumab) and inhibitors of the mammalian target of rapamycin pathway (i.e. temsirolimus and everolimus). These newer therapies have been shown to improve progression-free survival compared with previous approaches. Because most of these targeted agents are taken orally, responsibility for dose administration has shifted to patients, which might result in variable adherence. Additionally, with new treatments for metastatic renal cell carcinoma comes the challenge of selecting dosing schemes that maximize therapeutic benefit and minimize adverse events. Much of the information related to the effectiveness of dose modifications for targeted therapies in metastatic renal cell carcinoma has been gathered from clinical studies that have strict inclusion and exclusion criteria, which might not translate directly to real-world patient populations. This review discusses the impact of dose adherence on the effectiveness of targeted agents to treat metastatic renal cell carcinoma, assesses the literature regarding the effectiveness of approved dosing strategies, and provides a summary of alternative dosing strategies.

    Original languageEnglish (US)
    Pages (from-to)43-55
    Number of pages13
    JournalJournal of Oncology Pharmacy Practice
    Volume23
    Issue number1
    DOIs
    StatePublished - Jan 1 2017

    Fingerprint

    Renal Cell Carcinoma
    Therapeutics
    Sirolimus
    Standard of Care
    Interferons
    Vascular Endothelial Growth Factor A
    Disease-Free Survival
    Interleukin-2
    Cytokines
    Population

    Keywords

    • Dosing
    • mTOR inhibitor
    • renal cell carcinoma
    • targeted therapy
    • VEGFR inhibitor

    ASJC Scopus subject areas

    • Oncology
    • Pharmacology (medical)

    Cite this

    Dosing strategies and optimization of targeted therapy in advanced renal cell carcinoma. / Ryan, Christopher.

    In: Journal of Oncology Pharmacy Practice, Vol. 23, No. 1, 01.01.2017, p. 43-55.

    Research output: Contribution to journalReview article

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