Editor’s Pick: Targeted Agents in Patients with Metastatic Renal Cell Carcinoma on Dialysis: Myths and Reality - European Medical Journal

Editor’s Pick: Targeted Agents in Patients with Metastatic Renal Cell Carcinoma on Dialysis: Myths and Reality

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Annalisa Guida,1 Laura Cosmai,2,3 Fabio Gelsomino,1 Cristina Masini,4 Roberto Sabbatini,1 *Camillo Porta3,5

The authors have declared no conflicts of interest.

EMJ Nephrol. ;4[1]:66-77. DOI/10.33590/emjnephrol/10312156. https://doi.org/10.33590/emjnephrol/10312156.
Vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor (VEGFR) targeting agents, mammalian target of rapamycin (mTOR) inhibitors, dialysis, end-stage renal disease (ESRD)

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Agents targeting the vascular endothelial growth factor (VEGF)/VEGF receptor (VEGFR) pathway, as well as mammalian target of rapamycin (mTOR) inhibitors have revolutionised the therapeutic landscape of metastatic renal cell carcinoma (mRCC) in the past decade, greatly improving the survival rates of these patients. However, translating results of registrative Phase III trials into everyday clinical practice is often troublesome, since real-world patients are completely different from those enrolled in randomised controlled Phase III trials. Prospective data on active oncological treatments in mRCC patients on dialysis are dramatically lacking. This literature review summarises and critically comments on available data relative to mRCC patients on dialysis receiving either VEGF/VEGFR-targeting agents, or mTOR inhibitors. Although prospective studies would definitely be warranted in these specific patient populations, all the available data suggest that mRCC patients on dialysis have the same outcome, both in terms of efficacy and safety, as mRCC patients with normal or marginally impaired kidney function, when treated with VEGF/VEGFR-targeting agents and/or mTOR inhibitors.

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