Abstract
Advanced or metastatic inoperable renal cell carcinoma (mRCC) remains an incurable disease despite significant advances in systemic treatment. Currently, there are seven targeted agents available in the Czech Republic.
Sunitinib, pazopanib, temsirolimus, or bevacizumab/ interferon-α can be used as first-line therapy, everolimus, axitinib, sorafenib, or (in selected patients) sunitinib can be used in the second line. Everolimus can also be used for third-line treatment.
The choice of a first-line targeted agent is influenced by results of prospective randomised clinical trials as well as clinical status of the patient and therapeutic intent. Recommendations for second- and third-line therapy contain many areas of uncertainty although there are some randomised and non-randomised studies that have provided guidance into optimal treatment selection.
Nevertheless, sequential therapy of mRCC remains hotly debated in the oncology community.