Renal cell carcinoma (RCC) is considered a chemotherapy-resistant tumor; the landscape of metastatic RCC (mRCC) is rapidly changing due to the development of target therapy. By now, 10 novel agents have dramatically improved the prognosis of mRCC. The purpose of this chapter is to provide an updated overview of the clinical data, which support the use of these agents. We conducted a systematic review using PubMed and ClinicalTrials.gov about target therapy in RCC according to the existing guidelines, made analysis of the clinic trials, and discussed their mechanism, impact on quality of life (QoL), and patient selection algorithms. A total of 11 completed phase III trials were included in our research data. Agreement was correlated with the availability of data in seven trials, contributing to the category 1 option of first-line therapy for patients with mRCC. Three completed phase III trials contributed for the subsequent therapy as the evidence. Target therapy shows promise in clinical practice. Guidelines and algorithms should be revised and adapted to the new target drugs. However, more research is needed in parallel to discover biomarkers that enable the prediction of a treatment response and therefore lead to better patient selection.
Part of the book: Evolving Trends in Kidney Cancer