Journal of Kidney Cancer and VHL (Sep 2022)

Current Options for Second-Line Systemic Therapy in Metastatic Renal Cell Carcinoma

  • Iraklis C. Mitsogiannis,
  • Maria Mitsogianni,
  • Maria Papathanassiou,
  • Maria Anagnostou,
  • Ioannis Tamposis,
  • Lampros Mitrakas,
  • Maria Samara,
  • Vassilios Tzortzis,
  • Panagiotis J. Vlachostergios

DOI
https://doi.org/10.15586/jkcvhl.v9i3.243
Journal volume & issue
Vol. 9, no. 3

Abstract

Read online

Standard systemic therapy of advanced renal cell carcinoma (RCC) involves targeting angiogenesis, mainly through tyrosine kinase inhibitors (TKI) against the vascular endothelial growth factor receptor (VEGFR) pathway and targeting the immune checkpoints, namely, programmed death-1 (PD-1) or its ligand (PD-L1), and cytotoxic T-lymphocyte-associated protein 4 (CTLA4). With current strategies of combining these two approaches in the front-line setting, less is known about optimal selection of therapy upon development of resistance in the second and later lines of treatment for progressive disease. This review discusses currently available therapeutic options in patients who have progressive RCC after prior treatment with double immune check-point inhibitors (ICIs) or ICI-TKI combinations.

Keywords