Saturday, May 11, 2013

MTOR Inhibitor ....

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

----------------------------------------------------------------------------------------------
TREATMENT RECOMMENDATION FOR CLEAR CELL RENAL CELL CANCER

SETTING                          PATIENT                    LEVEL 1                            HIGHER LEVEL
---------------------------------------------------------------------------------------------------
                                       Good or                        Sunitinib
                                   Intermediate risk           Bevaczumab +INF-alpha         high dose IL2
1st line                                                              Pazopanib                               Sorafenib
                                   ---------------------------------------------------------------------------

                                    Poor risk                      Temsirolimus                    
                                                                         (Sunitinib)
==================================================================
                                                                        Sorafenib                                  Sunitinib
                                   Prior Cytokine               Pazopanib                               Bevacizumab
2nd and 3rd line          ----------------------------------------------------------------------------

                                   Prior VEGF-TKI           Everolimus or Axitinib              Sorafenib
                                   Prior MTOR Inhib.        Axitinib

=================================================================

from Molina et al....
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