Renal cell carcinoma (RCC) is one of the most common diseases of the urological system, which has a poor prognosis and low survival rate. Over 50% of patients are diagnosed with localized RCC which is primarily treated with surgery and can potentially be cured by total or partial nephrectomy. However, the remaining patients with advanced RCC or patients who relapse after local therapy require systemic treatment and therapies. Advanced RCC has been found to be highly resistant to conventional cytotoxic chemotherapy. Over the years, there has been significant development in the treatment for metastatic RCC patients to improve the survival rate and prognosis. Targeted anti-angiogenic agents have increased anti-tumor activity compared to cytokines and studies have demonstrated it increases the survival rate of RCC patients.
Sunitinib and sorafenib are most commonly the first-line drugs to treat metastatic RCC and are known as tyrosine kinase inhibitors (TKIs). These drugs have various targets and have the ability to inhibit vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF) receptor tyrosine kinases. Sorafenib can also disrupt the RAS/RAF/MEK intracellular signaling pathway. Immunotherapy has also been evolving over time which has improved the survival rate with combinations of treatment such as nivolumab/ipilimumab, avelumab/axitinib, and pembrolizumab/axitinib, which have been alternative choices for first-line and second-line therapy. So far, seven TKIs and anti-angiogenic agents have been officially approved including sunitinib, pazopanib, axitinib, cabozantinib, and tivozanib. The development of anti-angiogenic therapy will proceed to be one of the main strategies to help improve the survival of RCC patients. Further anti-angiogenic TKIs which include cabozantinib and lenvatinib have additional targets such as the fibroblast growth factor receptor (FGFR), AXL and MET. FGFR pathway can be a factor which influences the escape of anti-VEGF/VEGFR therapy and therefore, may be more effective on inhibitory activity on FGFR if VEGFR TKI are unsuccessful. Further studies are required to understand how the TKIs influence the molecular pathways.
The aim of this Research Topic is to discuss how tyrosine kinase inhibitors (TKIs) impact the survival rate and prognosis for metastatic renal cell carcinoma (mRCC) patients. We welcome Original Research Articles, Review Articles, Systematic Reviews and Case Reports.
Please note: manuscripts consisting solely of bioinformatics or computational analysis of public genomic or transcriptomic databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) are out of scope for this section and will not be accepted as part of this Research Topic.
Renal cell carcinoma (RCC) is one of the most common diseases of the urological system, which has a poor prognosis and low survival rate. Over 50% of patients are diagnosed with localized RCC which is primarily treated with surgery and can potentially be cured by total or partial nephrectomy. However, the remaining patients with advanced RCC or patients who relapse after local therapy require systemic treatment and therapies. Advanced RCC has been found to be highly resistant to conventional cytotoxic chemotherapy. Over the years, there has been significant development in the treatment for metastatic RCC patients to improve the survival rate and prognosis. Targeted anti-angiogenic agents have increased anti-tumor activity compared to cytokines and studies have demonstrated it increases the survival rate of RCC patients.
Sunitinib and sorafenib are most commonly the first-line drugs to treat metastatic RCC and are known as tyrosine kinase inhibitors (TKIs). These drugs have various targets and have the ability to inhibit vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF) receptor tyrosine kinases. Sorafenib can also disrupt the RAS/RAF/MEK intracellular signaling pathway. Immunotherapy has also been evolving over time which has improved the survival rate with combinations of treatment such as nivolumab/ipilimumab, avelumab/axitinib, and pembrolizumab/axitinib, which have been alternative choices for first-line and second-line therapy. So far, seven TKIs and anti-angiogenic agents have been officially approved including sunitinib, pazopanib, axitinib, cabozantinib, and tivozanib. The development of anti-angiogenic therapy will proceed to be one of the main strategies to help improve the survival of RCC patients. Further anti-angiogenic TKIs which include cabozantinib and lenvatinib have additional targets such as the fibroblast growth factor receptor (FGFR), AXL and MET. FGFR pathway can be a factor which influences the escape of anti-VEGF/VEGFR therapy and therefore, may be more effective on inhibitory activity on FGFR if VEGFR TKI are unsuccessful. Further studies are required to understand how the TKIs influence the molecular pathways.
The aim of this Research Topic is to discuss how tyrosine kinase inhibitors (TKIs) impact the survival rate and prognosis for metastatic renal cell carcinoma (mRCC) patients. We welcome Original Research Articles, Review Articles, Systematic Reviews and Case Reports.
Please note: manuscripts consisting solely of bioinformatics or computational analysis of public genomic or transcriptomic databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) are out of scope for this section and will not be accepted as part of this Research Topic.
