AI Insight
This commentary discusses the evolution of second-line treatment strategies for metastatic clear-cell renal cell carcinoma over the past decade. The standard approach involved sequential use of VEGFR-tyrosine-kinase inhibitors, with key trials establishing the progression from cytokine-refractory treatments (TARGET trial) to axitinib superiority over sorafenib (AXIS trial) and ultimately cabozantinib as the second-line standard of care (METEOR trial).
Why it matters
This article provides important context for how treatment paradigms for advanced kidney cancer have evolved, informing clinical decision-making for physicians treating patients who have progressed on initial therapy. The sequential trial evidence has shaped current standard-of-care recommendations for this patient population.
Understand the Science
For more than a decade, the question of what to offer patients with metastatic clear-cell renal cell carcinoma after front-line therapy was familiar. Treatment consisted of a VEGFR-tyrosine-kinase inhibitor, frequently sequenced after another. The framework began with the TARGET trial1 in patients with cytokine-refractory disease, and matured in the post-VEGFR-tyrosine-kinase inhibitor population through the AXIS trial,2 which showed superiority of axitinib over sorafenib, and the pivotal METEOR trial,3 which established cabozantinib as a second-line standard of care.
Source: [Comment] Redefining therapy for previously treated renal cell carcinoma