Choices and clinical trials in early kidney cancer therapy
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Choices and clinical trials in early kidney cancer therapy. E2805 adjuvant sorafenib of sunitinib or placebo post surgeryopen at CPMC ARISER - Adjuvant Rencarex (WX-G250)intravenous monoclonal antibodyavailable at UCSF.

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Choices and clinical trials in early kidney cancer therapy

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Choices and clinical trials in early kidney cancer therapy

E2805 adjuvant sorafenib of sunitinib or placebo post surgeryopen at CPMC

ARISER - Adjuvant Rencarex (WX-G250)intravenous monoclonal antibodyavailable at UCSF


Choices First-line Therapy for Stage IV kidney cancer

  • High-dose Interleukin-2-most toxic

  • Sunitinib (Sutent) oral, moderate side effects

  • Sorabenib (Nexavar) oral, fewer side effects

  • Bevacizumab with interferon-final data available this summer

  • Interferon alone- inferior

  • Temsirolimus (Torisel) probably available this spring

  • Clinical Trial


Clinical Trials: What and Why

  • Phase I, Phase II, Phase III-decreasing risk

  • A biologic experiment with humans

  • Access to a new therapy that may be better

  • Access to expertise not available next door

  • Closer monitoring of your cancer and of treatment side effects

  • Choose a trial specifically for kidney cancer


Trials at California Kidney Cancer Center 2007

  • Renal EFFECT trial--first line stage 42 different doses of sunitinib50mg/day 4weeks on, 2 off37.5 mg/day, every day

  • TRIST trial Trovax vaccine with sunitinib

  • RAD001 trial mTOR inhibitor 2nd, 3rd line versus placebo

  • E2805 adjuvant study stage 2 or 3 post-op


Choices for second-line therapy

Clinical Trial

Temsirolimus vs. sorafenib after sunitinib- trial planned

Immunotherapy with high-dose IL-2

Change from sorafenib/sunitinib to bevacizumab

Change from bevacizumab to sorafenib or sunitinib

Change from immunotherapy to targeted therapy

Temsirolimus (Torisel)


Combinations of Targeted Therapies

  • Sorafenib with bevacizumab phase 1toxicities required dose reductions42% response rate

  • Sunitinib with bevacizumab trial in progress

  • Temsirolimus with bevacizumab

    trial planned

  • Temsirolimus with sorafenib in progress

    Phase III trial planned

  • Many other combinations possible


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