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Authors Tan X, Liu Y, Hou J, Cao G
Published Date January 2015 Volume 2015:8 Pages 313—321
DOI http://dx.doi.org/10.2147/OTT.S64660
Received 1 December 2014, Accepted 14 January 2015, Published 29 January 2015
Abstract: Renal cell
carcinoma (RCC) is the most common type of cancer arising from the kidney, with
a male to female ratio of 2:1. The incidence of RCC is rising. In males, it was
the seventh most common cancer in the People’s Republic of China in 2012. RCC
is resistant to radiotherapy and chemotherapy, but approximately 20% of
patients with advanced RCC respond to immunotherapy. Novel therapies targeting
angiogenesis and signaling pathways have been proven to be effective for
advanced or metastatic RCC in western countries. Due to the heterogeneity of
RCC between races, it is necessary to have an overview of targeted therapies,
especially everolimus, for patients with advanced RCC in the People’s Republic
of China. Three targeted therapeutic agents have been approved in Mainland
China for the treatment of patients with advanced RCC, ie, two tyrosine kinase
inhibitors (sorafenib and sunitinib) and one mammalian target of rapamycin
(mTOR) inhibitor (everolimus). Compared with western patients with advanced or
metastatic RCC, Chinese patients with the same disease respond better to
sorafenib and sunitinib as first-line targeted therapy, but sunitinib has a
relatively higher risk of toxicity. Everolimus, an mTOR inhibitor that can be
administered orally, is well tolerated and acceptable to Chinese patients.
Everolimus has competitive advantages as second-line targeted treatment for
Chinese patients with advanced RCC who are resistant to first-line tyrosine
kinase inhibitors. Despite a lack of noninferiority when compared with
sunitinib as first-line therapy, the sunitinib-everolimus paradigm is still
recommended as standard therapy for patients with advanced RCC. Although most
studies of targeted therapies for advanced RCC have obvious limitations, such
as small sample size and retrospective design, up-to-date evidence indicates
that everolimus would be an ideal agent as second-line targeted treatment for
advanced or metastatic RCC in the People’s Republic of China.
Keywords: target therapy, renal
cell carcinoma, everolimus, People’s Republic of China