THE NOTION THAT MTOR INHIBITOR SHOULD FOLLOW VEGF INHIBITOR FAILURE HAS BEEN ADOPTED BY THE MSKCC PHASE 3 STUDY OF Anti-PD1 ANTIBODY (BMS) vs EVEROLIMUS "FOLLOWING VEGF-TARGETED THERAPY FOR RENAL CANCER.
In this study, patients with Renal cell cancer who have progressed after 1 or 2 anti-VEGF systemic treatments are randomized to Anti-PD1 Antibody or Everolimus.
The primary endpoint is survival whereas secondary endpoints include progression free survival, safety of drugs and quality of life!
Please access the trial through clinicaltrials.gov
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TREATMENT RECOMMENDATION FOR CLEAR CELL RENAL CELL CANCER
SETTING PATIENT LEVEL 1 HIGHER LEVEL
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Good or Sunitinib
Intermediate risk Bevaczumab +INF-alpha high dose IL2
1st line Pazopanib Sorafenib
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Poor risk Temsirolimus
(Sunitinib)
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Sorafenib Sunitinib
Prior Cytokine Pazopanib Bevacizumab
2nd and 3rd line ----------------------------------------------------------------------------
Prior VEGF-TKI Everolimus or Axitinib Sorafenib
Prior MTOR Inhib. Axitinib
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from Molina et al....
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