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Renal cell carcinoma (RCC) is the most common form of kidney cancer and is difficult to treat once it has metastasised (spread) to other parts of the body.
Recently, several new therapies were approved for first-line treatment of the disease including sorafenib (Nexavar) and sunitinib (Sutent). They are, however, not without side effects. Patients treated with sunitinib, for example, may experience costs that are two to three times greater than if they were treated with bevacizumab (Avastin) and interferon (IFN), a combination which provides comparable patient efficacy to sunitinib. Sorafenib, sunitinib and bevacizumab are all inhibitors of vascular endothelial growth factor (VEGF), which is thought to play a critical role in tumour angiogenesis.
At the ASCO meeting in Chicago this weekend, data was presented on a new drug in development from Novartis. Patients with metastatic RCC who received
everolimus (RAD001) experienced significantly improved progression-free survival
than those who received standard care. At 6 months, patients treated with everolimus had not progressed in 26% of cases compared with those treated with placebo (2%). The median
progression-free survival (PFS) was 4 months in the everolimus group and 1.9
months in the placebo group. All of these patients had previous received either sorafenib or sunitinib or both and had stopped responding to therapy.
Everolimus is a different class of compound; it is a derivative of the natural macrocyclic lactone sirolimus
and has both immunosuppressant and antiangiogenic properties. It
targets the cellular protein mTOR, a regulator of signaling pathways
associated with the abnormal growth, proliferation, and survival of
cancer cells. In addition to RCC, Novartis are currently evaluating it for
the treatment of several cancers, including lymphoma and
These latest data suggest that it may offer a viable treatment option in RCC for those patients whose tumours stop responding to the anti-VEGF therapies.