Clinical Medicine Reviews in Oncology

Surgically unresectable renal cell carcinoma (RCC) is an incurable condition. This is due to RCC’s inherent chemo resistance. Cytokine therapy until recently was the mainstay of treatment. However, it showed modest response. Current advances in the understanding of the biology of RCC have resulted in the development of targeted agents. These agents include multi kinase inhibitors like Sunitinib and Sorafenib, humanized monoclonal antibody ie, Bevacizumab and Temsirolimus, a selective inhibitor of mammalian target of rapamycin (mTOR). Temsirolimus is recommended as a first line agent in poor prognosis patients with metastatic RCC. There is also emerging data on the safety and efficacy of temsirolimus in a cohort of pre-treated intermediate to poor prognosis patients with metastatic RCC. Temsirolimus has also shown better outcome over interferon α in quality-adjusted time without symptoms of progression or toxicity analysis.