Often cancer can be traced back to a translocation e.g. blood cancers such as leukemias or a gene addition/subtraction as found with many solid tumours such as breast cancer.
It has been known that kidney or renal cell cancer is linked to the Von Hippel Lindau (VHL) gene, where the tumour develops when the gene is faulty. A normal VHL gene usually protects against developing cancer.
Approximately 30,000 people are affected by renal cancer in Europe and the United States. Recently, two new drugs were approved in the US which are regulated by other pathways associated with this gene. One was Nexavar from Bayer and the other Sutent from Pfizer. Response rates of 20-30% were typically seen, which although low, is still promising compared to standard therapy such as IL-2 and interferon-alpha with more tolerable side effects. Screening patients for defects in the VHL gene may lead to higher response rates and survival using a more targeted approach to patient selection.
Click Here for more information on the mutant VHL gene news.
Other therapeutic approaches to the treatment of renal cancer are also being considered including m-Tor inhibitors such as temsirolimus (Torisel) from Wyeth. This agent induces apoptosis and reduces cell proliferation and may offer an exciting new approach to the treatment of the disease. Novartis also a potent mTor inhibitor in development called Afinitor (RAD001, everolimus), which is expected to be available in 2009 in the US.
Ultimately, the optimal treatment may include a multi-faceted approach whereby different drugs can be used in sequence or in combination to attack different pathways associated with the disease, increasing chances of success and reducing to opportunities for drug resistance to develop.
New data will likely be available at the American Society of Clinical Oncology meeting in June; let’s hope it is promising!