Sequential VEGFR-Targeted Therapy for Advanced Renal Cancer

A number of agents that inhibit vascular endothelial growth factor (VEGF) are routinely used as initial therapy for patients with good- and intermediate-risk metastatic clear-cell renal cancer. Following disease progression on a first-line VEGF inhibitor, several agents can be used as second-line therapy. Randomized trials have compared VEGF inhibitors agents following disease progression on sunitinib (axitinib versus sorafenib; NEJM JW Oncol Hematol Nov 15 2011) or the mammalian target of rapamycin inhibitor (mTor) everolimus versus placebo (NEJM JW Oncol Hematol Jul 29 2008). However, no prospective studies have compared VEGF inhibitors with mTor inhibition in this setting.

Now, a group of international investigators has conducted an indus…