Angiogenesis inhibition in renal cell cancer

Abstract

Several targets have been identified for the therapy of metastatic renal cell carcinoma (RCC). The recognition of hypoxia-inducible factor-α signaling in the pathogenesis of clear-cell RCC has led to widespread study of angiogenesis inhibitors. Understanding this molecular pathogenesis of RCC led to a rapid evolvement of new systemic therapies, with seven targeted therapies approved and several more agents in late-stage clinical development. Due to the results of the currently used targeted therapies, the progression-free survival could be prolonged and the overall survival in sequential therapy can reach up to 40 months. The development of validated guidelines for sequential treatment or combination of targeted therapy remains a current challenge.Kidney cancer or renal cell carcinoma (RCC) affects more than 150,000 people annually worldwide, resulting in 78,000 deaths each year, and its incidence seems to be rising. Cigarette smoking and hypertension are established risk factors for RCC, and RCC seems to be more common in patients with obesity, end-stage renal failure, acquired renal cystic disease, and tuberous sclerosis. Approximately 3 % of RCC are hereditary, and several autosomal dominant syndromes have been described, each with a distinct genetic basis and phenotype, the most common being von Hippel-Lindau (VHL) disease [1]. More than 50 % of patients with RCC are cured in early stages; how-N. Leonhartsberger, MD ()

Angiogenesis

“…Also in urological malignancies, anti-angiogenic therapies are attractive concepts and already incorporated in the daily uro-oncological practice as reported by Leonhartsberger [4] in renal cell cancer. However, in castration-resistant prostate cancer (CRPC), until now, no anti-angiogenic therapy is approved, and therefore, Heidegger et al [5] discuss critically the results and limitations of performed studies with anti-angiogenic agents in CRPC.…”