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Recommendations from the Spanish Oncology Genitourinary Group for the treatment of patients with renal cell carcinoma

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Abstract

Clear-cell renal cell carcinoma (RCC) is the most common kidney cancer. New treatment options of localized RCC recently incorporated include laparoscopic surgery, nephron-sparing surgery, ablative techniques and active surveillance. But 50 % of patients may develop disease recurrence attributable to subclinical metastases. In these cases, and considering the low benefits of chemotherapy, new targeted therapies such as tyrosine kinase inhibitors (TKIs) and mammalian target of rapamycin (mTOR) inhibitors have been developed as first- and second-line treatment. Both sunitinib and pazopanib are TKIs that constitute the first-line treatment option in patients with metastatic RCC. As second-line treatment, sequential therapy with a second TKI or a mTOR inhibitor is recommended. This review has collected together a series of recommendations issued by the Spanish Oncology Genitourinary Group with the aim of facilitating the treatment of these patients. Each recommendation is accompanied by the level of evidence and grade of recommendation on the basis of the available data.

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Abbreviations

ASCO:

American Society of Clinical Oncology

CT:

Computed tomography

DFS:

Disease-free survival

ECOG:

Eastern Cooperative Oncology Group

EORTC:

European Organization for Research and Treatment of Cancer

ESMO:

European Society of Medical Oncology

HIFU:

High-intensity focused ultrasound

HR:

Hazard ratio

IL:

Interleukin

mTOR:

Mammalian target of rapamycin

OS:

Overall survival

PFS:

Progression-free survival

PS:

Performance status

RCC:

Renal cell carcinoma

SOGUG:

Spanish Oncology Genitourinary Group

SWOG:

Southwest Oncology Group

TKI:

Tyrosine kinase inhibitor

ULN:

Upper limit of normal

VEGF:

Vascular endothelial growth factor

VEGFR:

Vascular endothelia growth factor receptor

WHO:

World Health Organization

References

  1. Cohen HT, McGovern FJ (2005) Renal-cell carcinoma. N Engl J Med 353:2477–2490. doi:10.1056/NEJMra043172

    Article  CAS  PubMed  Google Scholar 

  2. Hillner BE, Ingle JN, Berenson JR, Janjan NA, Albain KS, Lipton A, Yee G, Biermann JS, Chlebowski RT, Pfister DG (2000) American society of clinical oncology guideline on the role of bisphosphonates in breast cancer. American society of clinical oncology bisphosphonates expert panel. J Clin Oncol 18:1378–1391

    CAS  PubMed  Google Scholar 

  3. Jeong W, Rha KH, Kim HH, Byun SS, Kwon TG, Seo IY, Sung GT, Jeon SH, Jeong YB, Hong SH (2011) Comparison of laparoscopic radical nephrectomy and open radical nephrectomy for pathologic stage T1 and T2 renal cell carcinoma with clear cell histologic features: a multi-institutional study. Urology 77:819–824. doi:10.1016/j.urology.2010.06.024

    Article  PubMed  Google Scholar 

  4. Rubio Briones J, Iborra Juan I, Casanova Ramon-Borja J, Solsona Narbon E (2006) Radical laparoscopic nephrectomy. Actas Urol Esp 30:479–491

    Article  CAS  PubMed  Google Scholar 

  5. Gill IS, Kavoussi LR, Lane BR, Blute ML, Babineau D, Colombo JR Jr, Frank I, Permpongkosol S, Weight CJ, Kaouk JH, Kattan MW, Novick AC (2007) Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. J Urol 178:41–46. doi:10.1016/j.juro.2007.03.038

    Article  PubMed  Google Scholar 

  6. Rubio Briones J, Estebanez Zarranz J, Dominguez Escrig JL (2009) Role of laparoscopy in the presence of a renal mass under 4 cm in size. Actas Urol Esp 33:534–543

    Article  PubMed  Google Scholar 

  7. Van Poppel H, Da Pozzo L, Albrecht W, Matveev V, Bono A, Borkowski A, Colombel M, Klotz L, Skinner E, Keane T, Marreaud S, Collette S, Sylvester R (2011) A prospective, randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma. Eur Urol 59:543–552. doi:10.1016/j.eururo.2010.12.013

    Article  PubMed  Google Scholar 

  8. Van Poppel H, Da Pozzo L, Albrecht W, Matveev V, Bono A, Borkowski A, Marechal JM, Klotz L, Skinner E, Keane T, Claessens I, Sylvester R (2007) A prospective randomized EORTC intergroup phase 3 study comparing the complications of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma. Eur Urol 51:1606–1615. doi:10.1016/j.eururo.2006.11.013

    Article  PubMed  Google Scholar 

  9. Kunkle DA, Uzzo RG (2008) Cryoablation or radiofrequency ablation of the small renal mass: a meta-analysis. Cancer 113:2671–2680. doi:10.1002/cncr.23896

    Article  PubMed Central  PubMed  Google Scholar 

  10. Jewett MA, Mattar K, Basiuk J, Morash CG, Pautler SE, Siemens DR, Tanguay S, Rendon RA, Gleave ME, Drachenberg DE, Chow R, Chung H, Chin JL, Fleshner NE, Evans AJ, Gallie BL, Haider MA, Kachura JR, Kurban G, Fernandes K, Finelli A (2011) Active surveillance of small renal masses: progression patterns of early stage kidney cancer. Eur Urol 60:39–44. doi:10.1016/j.eururo.2011.03.030

    Article  PubMed  Google Scholar 

  11. Jocham D, Richter A, Hoffmann L, Iwig K, Fahlenkamp D, Zakrzewski G, Schmitt E, Dannenberg T, Lehmacher W, von Wietersheim J, Doehn C (2004) Adjuvant autologous renal tumour cell vaccine and risk of tumour progression in patients with renal-cell carcinoma after radical nephrectomy: phase III, randomised controlled trial. Lancet 363:594–599. doi:10.1016/S0140-6736(04)15590-6

    Article  CAS  PubMed  Google Scholar 

  12. Wood C, Srivastava P, Bukowski R, Lacombe L, Gorelov AI, Gorelov S, Mulders P, Zielinski H, Hoos A, Teofilovici F, Isakov L, Flanigan R, Figlin R, Gupta R, Escudier B (2008) An adjuvant autologous therapeutic vaccine (HSPPC-96; vitespen) versus observation alone for patients at high risk of recurrence after nephrectomy for renal cell carcinoma: a multicentre, open-label, randomised phase III trial. Lancet 372:145–154. doi:10.1016/S0140-6736(08)60697-2

    Article  CAS  PubMed  Google Scholar 

  13. Atzpodien J, Schmitt E, Gertenbach U, Fornara P, Heynemann H, Maskow A, Ecke M, Woltjen HH, Jentsch H, Wieland W, Wandert T, Reitz M (2005) Adjuvant treatment with interleukin-2- and interferon-alpha2a-based chemoimmunotherapy in renal cell carcinoma post tumour nephrectomy: results of a prospectively randomised trial of the German Cooperative Renal Carcinoma Chemoimmunotherapy Group (DGCIN). Br J Cancer 92:843–846. doi:10.1038/sj.bjc.6602443

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  14. Scherr AJ, Lima JP, Sasse EC, Lima CS, Sasse AD (2011) Adjuvant therapy for locally advanced renal cell cancer: a systematic review with meta-analysis. BMC Cancer 11:115. doi:10.1186/1471-2407-11-115

    Article  PubMed Central  PubMed  Google Scholar 

  15. Jonasch E, Wood CG, Matin SF, Tu SM, Pagliaro LC, Corn PG, Aparicio A, Tamboli P, Millikan RE, Wang X, Araujo JC, Arap W, Tannir N (2009) Phase II presurgical feasibility study of bevacizumab in untreated patients with metastatic renal cell carcinoma. J Clin Oncol 27:4076–4081. doi:10.1200/JCO.2008.21.3660

    Article  CAS  PubMed  Google Scholar 

  16. Cowey CL, Amin C, Pruthi RS, Wallen EM, Nielsen ME, Grigson G, Watkins C, Nance KV, Crane J, Jalkut M, Moore DT, Kim WY, Godley PA, Whang YE, Fielding JR, Rathmell WK (2010) Neoadjuvant clinical trial with sorafenib for patients with stage II or higher renal cell carcinoma. J Clin Oncol 28:1502–1507. doi:10.1200/JCO.2009.24.7759

    Article  CAS  PubMed  Google Scholar 

  17. Hellenthal NJ, Underwood W, Penetrante R, Litwin A, Zhang S, Wilding GE, Teh BT, Kim HL (2010) Prospective clinical trial of preoperative sunitinib in patients with renal cell carcinoma. J Urol 184:859–864. doi:10.1016/j.juro.2010.05.041

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  18. Powles T, Kayani I, Blank C, Chowdhury S, Horenblas S, Peters J, Shamash J, Sarwar N, Boletti K, Sadev A, O’Brien T, Berney D, Beltran L, Haanen J, Bex A (2011) The safety and efficacy of sunitinib before planned nephrectomy in metastatic clear cell renal cancer. Ann Oncol 22:1041–1047. doi:10.1093/annonc/mdq564

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Flanigan RC, Salmon SE, Blumenstein BA, Bearman SI, Roy V, McGrath PC, Caton JR Jr, Munshi N, Crawford ED (2001) Nephrectomy followed by interferon alfa-2b compared with interferon alfa-2b alone for metastatic renal-cell cancer. N Engl J Med 345:1655–1659. doi:10.1056/NEJMoa003013

    Article  CAS  PubMed  Google Scholar 

  20. Mickisch GH, Garin A, van Poppel H, de Prijck L, Sylvester R (2001) Radical nephrectomy plus interferon-alfa-based immunotherapy compared with interferon alfa alone in metastatic renal-cell carcinoma: a randomised trial. Lancet 358:966–970

    Article  CAS  PubMed  Google Scholar 

  21. Choueiri TK, Xie W, Kollmannsberger C, North S, Knox JJ, Lampard JG, McDermott DF, Rini BI, Heng DY (2011) The impact of cytoreductive nephrectomy on survival of patients with metastatic renal cell carcinoma receiving vascular endothelial growth factor targeted therapy. J Urol 185:60–66. doi:10.1016/j.juro.2010.09.012

    Article  PubMed  Google Scholar 

  22. Kavolius JP, Mastorakos DP, Pavlovich C, Russo P, Burt ME, Brady MS (1998) Resection of metastatic renal cell carcinoma. J Clin Oncol 16:2261–2266

    CAS  PubMed  Google Scholar 

  23. Yang JC, Abad J, Sherry R (2006) Treatment of oligometastases after successful immunotherapy. Semin Radiat Oncol 16:131–135. doi:10.1016/j.semradonc.2005.12.008

    Article  PubMed  Google Scholar 

  24. Karam JA, Rini BI, Varella L, Garcia JA, Dreicer R, Choueiri TK, Jonasch E, Matin SF, Campbell SC, Wood CG, Tannir NM (2011) Metastasectomy after targeted therapy in patients with advanced renal cell carcinoma. J Urol 185:439–444. doi:10.1016/j.juro.2010.09.086

    Article  PubMed  Google Scholar 

  25. Veronesi G, Petrella F, Leo F, Solli P, Maissoneuve P, Galetta D, Gasparri R, Pelosi G, De Pas T, Spaggiari L (2007) Prognostic role of lymph node involvement in lung metastasectomy. J Thorac Cardiovasc Surg 133:967–972. doi:10.1016/j.jtcvs.2006.09.104

    Article  PubMed  Google Scholar 

  26. Motzer RJ, Hutson TE, Tomczak P, Michaelson MD, Bukowski RM, Rixe O, Oudard S, Negrier S, Szczylik C, Kim ST, Chen I, Bycott PW, Baum CM, Figlin RA (2007) Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Engl J Med 356:115–124. doi:10.1056/NEJMoa065044

    Article  CAS  PubMed  Google Scholar 

  27. Escudier B, Pluzanska A, Koralewski P, Ravaud A, Bracarda S, Szczylik C, Chevreau C, Filipek M, Melichar B, Bajetta E, Gorbunova V, Bay JO, Bodrogi I, Jagiello-Gruszfeld A, Moore N (2007) Bevacizumab plus interferon alfa-2a for treatment of metastatic renal cell carcinoma: a randomised, double-blind phase III trial. Lancet 370:2103–2111. doi:10.1016/S0140-6736(07)61904-7

    Article  PubMed  Google Scholar 

  28. Rini BI, Halabi S, Rosenberg JE, Stadler WM, Vaena DA, Ou SS, Archer L, Atkins JN, Picus J, Czaykowski P, Dutcher J, Small EJ (2008) Bevacizumab plus interferon alfa compared with interferon alfa monotherapy in patients with metastatic renal cell carcinoma: CALGB 90206. J Clin Oncol 26:5422–5428. doi:10.1200/JCO.2008.16.9847

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  29. Sternberg CN, Davis ID, Mardiak J, Szczylik C, Lee E, Wagstaff J, Barrios CH, Salman P, Gladkov OA, Kavina A, Zarba JJ, Chen M, McCann L, Pandite L, Roychowdhury DF, Hawkins RE (2010) Pazopanib in locally advanced or metastatic renal cell carcinoma: results of a randomized phase III trial. J Clin Oncol 28:1061–1068. doi:10.1200/JCO.2009.23.9764

    Article  CAS  PubMed  Google Scholar 

  30. Motzer RJ, Nosov D, Eisen T, Bondarenko I, Lesovoy V, Lipatov O, Tomczak P, Lyulko O, Alyasova A, Harza M, Kogan M, Alekseev BY, Sternberg CN, Szczylik C, Cella D, Ivanescu C, Krivoshik A, Strahs A, Esteves B, Berkenblit A, Hutson TE (2013) Tivozanib versus sorafenib as initial targeted therapy for patients with metastatic renal cell carcinoma: results from a phase III trial. J Clin Oncol 31:3791–3799. doi:10.1200/JCO.2012.47.4940

    Article  CAS  PubMed  Google Scholar 

  31. Motzer RJ, Hutson TE, Cella D, Reeves J, Hawkins R, Guo J, Nathan P, Staehler M, de Souza P, Merchan JR, Boleti E, Fife K, Jin J, Jones R, Uemura H, De Giorgi U, Harmenberg U, Wang J, Sternberg CN, Deen K, McCann L, Hackshaw MD, Crescenzo R, Pandite LN, Choueiri TK (2013) Pazopanib versus sunitinib in metastatic renal-cell carcinoma. N Engl J Med 369:722–731. doi:10.1056/NEJMoa1303989

    Article  CAS  PubMed  Google Scholar 

  32. Escudier BJ, Porta C, Bono P, De Giorgi U, Parikh O, Hawkins RE, Sevin E, Negrier S, Khan S, McCann L, Mehmud F, Cella D (2012) Patient preference between pazopanib (Paz) and sunitinib (Sun): results of a randomized double-blind, placebo-controlled, cross-over study in patients with metastatic renal cell carcinoma (mRCC)—PISCES study, NCT 01064310. ASCO meeting. Abstracts 30: Abstract CRA4502

  33. Hutson TE, Gallardo J, Lesovoy V, Al-Shukri S, Stus V, Bair AH, Rosbrook B, Bycott PW, Tarazi JC, Kim S, Vogelzang NJ (2013) Axitinib versus sorafenib as first-line therapy in patients with metastatic renal cell carcinoma (mRCC). ASCO meeting. Abstracts 31:LBA348

  34. Ravaud A, Barrios C, Anak O, Pelov D, Louveau A, Alekseev B, M-H T, Agarwala SS, Yalcin S, Melichar B (2012) Randomized phase II study of first-line everolimus + bevacizumab versus interferon alfa 2a +bevacizumab in patients with metastatic renal cell carcinoma: RECORD-2. 37th ESMO Congress: Abstract 7830

  35. Rini BI, Bellmunt J, Clancy J, Wang K, Niethammer A, Escudier B (2012) Randomized Phase IIIb trial of temsirolimus and bevacizumab versus interferon and bevacizumab in metastatic renal cell carcinoma: results from INTORACT 37th ESMO congress: Abstract LBA21_PR

  36. Negrier S, Gravis G, Perol D, Chevreau C, Delva R, Bay JO, Blanc E, Ferlay C, Geoffrois L, Rolland F, Legouffe E, Sevin E, Laguerre B, Escudier B (2011) Temsirolimus and bevacizumab, or sunitinib, or interferon alfa and bevacizumab for patients with advanced renal cell carcinoma (TORAVA): a randomised phase 2 trial. Lancet Oncol 12:673–680. doi:10.1016/S1470-2045(11)70124-3

    Article  CAS  PubMed  Google Scholar 

  37. Hudes G, Carducci M, Tomczak P, Dutcher J, Figlin R, Kapoor A, Staroslawska E, Sosman J, McDermott D, Bodrogi I, Kovacevic Z, Lesovoy V, Schmidt-Wolf IG, Barbarash O, Gokmen E, O’Toole T, Lustgarten S, Moore L, Motzer RJ (2007) Temsirolimus, interferon alfa, or both for advanced renal-cell carcinoma. N Engl J Med 356:2271–2281. doi:10.1056/NEJMoa066838

    Article  CAS  PubMed  Google Scholar 

  38. Di Lorenzo G, Carteni G, Autorino R, Bruni G, Tudini M, Rizzo M, Aieta M, Gonnella A, Rescigno P, Perdona S, Giannarini G, Pignata S, Longo N, Palmieri G, Imbimbo C, De Laurentiis M, Mirone V, Ficorella C, De Placido S (2009) Phase II study of sorafenib in patients with sunitinib-refractory metastatic renal cell cancer. J Clin Oncol 27:4469–4474. doi:10.1200/JCO.2009.22.6480

    Article  PubMed  Google Scholar 

  39. Rini BI, Escudier B, Tomczak P, Kaprin A, Szczylik C, Hutson TE, Michaelson MD, Gorbunova VA, Gore ME, Rusakov IG, Negrier S, Ou YC, Castellano D, Lim HY, Uemura H, Tarazi J, Cella D, Chen C, Rosbrook B, Kim S, Motzer RJ (2011) Comparative effectiveness of axitinib versus sorafenib in advanced renal cell carcinoma (AXIS): a randomised phase 3 trial. Lancet 378:1931–1939. doi:10.1016/S0140-6736(11)61613-9

    Article  CAS  PubMed  Google Scholar 

  40. Zama IN, Hutson TE, Elson P, Cleary JM, Choueiri TK, Heng DY, Ramaiya N, Michaelson MD, Garcia JA, Knox JJ, Escudier B, Rini BI (2010) Sunitinib rechallenge in metastatic renal cell carcinoma patients. Cancer 116:5400–5406. doi:10.1002/cncr.25583

    Article  CAS  PubMed  Google Scholar 

  41. Motzer RJ, Escudier B, Oudard S, Hutson TE, Porta C, Bracarda S, Grunwald V, Thompson JA, Figlin RA, Hollaender N, Urbanowitz G, Berg WJ, Kay A, Lebwohl D, Ravaud A (2008) Efficacy of everolimus in advanced renal cell carcinoma: a double-blind, randomised, placebo-controlled phase III trial. Lancet 372:449–456. doi:10.1016/S0140-6736(08)61039-9

    Article  CAS  PubMed  Google Scholar 

  42. Motzer RJ, Barrios CH, Kim TM, Falcon S, Cosgriff T, Harker WG, Pittman KB, Sabbatini R, Rha SY, Flaig TW, Page RD, Bavbek SE, Beck JT, Patel PM, Schiff E, Vaury A, Niolat J, Gogov S, Anak O, Knox J (2013) Record-3: phase II randomized trial comparing sequential first-line everolimus (EVE) and second-line sunitinib (SUN) versus first-line SUN and second-line EVE in patients with metastatic renal cell carcinoma (mRCC). ASCO meeting. Abstracts 31:4504

  43. Escudier B, Hutson TE, Esteban E, Bjarnason GA, Lim HY, Pittman K, Senico P, Niethammer A, Lu D, Hariharan S, Motzer RJ (2012) Temsirolimus vs Sorafenib as second line therapy in metastatic renal cell carcinoma: results from the INTORSECT trial. 37th ESMO congress: Abstract LBA22_PR

  44. Escudier B, Eisen T, Stadler WM, Szczylik C, Oudard S, Siebels M, Negrier S, Chevreau C, Solska E, Desai AA, Rolland F, Demkow T, Hutson TE, Gore M, Freeman S, Schwartz B, Shan M, Simantov R, Bukowski RM (2007) Sorafenib in advanced clear-cell renal-cell carcinoma. N Engl J Med 356:125–134. doi:10.1056/NEJMoa060655

    Article  CAS  PubMed  Google Scholar 

  45. Motzer R, Szczylik C, Vogelzang NJ, Sternberg CN, Porta C, Zolnierek J, Kollmannsberger C, Rha SY, Bjarnason GA, Melichar B, De Giorgi U, Urbanowitz G, Cai C, Shi M, Escudier B (2013) Phase 3 trial of dovitinib vs sorafenib in patients with metastatic renal cell carcinoma after 1 prior VEGF pathway–targeted and 1 prior mTOR inhibitor therapy. In: 38th ESMO congress, Amsterdam, Holland, 2013. Abstract 34

  46. Khambati H, Choueiri TK, Kollmannsberger CK, North S, Bjarnason GA, Vaishampayan UN, Wood L, MacKenzie MJ, Rini BI, Heng DY, International m RCCDC (2011) Efficacy of targeted drug therapy for metastatic renal cell carcinoma in the elderly patient population. ASCO meeting. Abstracts 29: Abstract 318

  47. Khosravan R, Toh M, Garrett M, La Fargue J, Ni G, Marbury TC, Swan SK, Lunde NM, Bello CL (2010) Pharmacokinetics and safety of sunitinib malate in subjects with impaired renal function. J Clin Pharmacol 50:472–481. doi:10.1177/0091270009347868

    Article  CAS  PubMed  Google Scholar 

  48. Lunardi G, Armirotti A, Nicodemo M, Cavallini L, Damonte G, Vannozzi MO, Venturini M (2009) Comparison of temsirolimus pharmacokinetics in patients with renal cell carcinoma not receiving dialysis and those receiving hemodialysis: a case series. Clin Ther 31:1812–1819. doi:10.1016/j.clinthera.2009.08.018

    Article  CAS  PubMed  Google Scholar 

  49. Bello CL, Garrett M, Sherman L, Smeraglia J, Ryan B, Toh M (2010) Pharmacokinetics of sunitinib malate in subjects with hepatic impairment. Cancer Chemother Pharmacol 66:699–707. doi:10.1007/s00280-009-1213-4

    Article  CAS  PubMed  Google Scholar 

  50. Stadler WM, Figlin RA, McDermott DF, Dutcher JP, Knox JJ, Miller WH Jr, Hainsworth JD, Henderson CA, George JR, Hajdenberg J, Kindwall-Keller TL, Ernstoff MS, Drabkin HA, Curti BD, Chu L, Ryan CW, Hotte SJ, Xia C, Cupit L, Bukowski RM (2010) Safety and efficacy results of the advanced renal cell carcinoma sorafenib expanded access program in North America. Cancer 116:1272–1280. doi:10.1002/cncr.24864

    Article  CAS  PubMed  Google Scholar 

  51. Wronski M, Arbit E, Russo P, Galicich JH (1996) Surgical resection of brain metastases from renal cell carcinoma in 50 patients. Urology 47:187–193. doi:10.1016/S0090-4295(99)80413-0

    Article  CAS  PubMed  Google Scholar 

  52. Lipton A, Colombo-Berra A, Bukowski RM, Rosen L, Zheng M, Urbanowitz G (2004) Skeletal complications in patients with bone metastases from renal cell carcinoma and therapeutic benefits of zoledronic acid. Clin Cancer Res 10:6397S–6403S. doi:10.1158/1078-0432.CCR-040030

    Article  CAS  PubMed  Google Scholar 

  53. Christodoulou C, Pervena A, Klouvas G, Galani E, Falagas ME, Tsakalos G, Visvikis A, Nikolakopoulou A, Acholos V, Karapanagiotidis G, Batziou E, Skarlos DV (2009) Combination of bisphosphonates and antiangiogenic factors induces osteonecrosis of the jaw more frequently than bisphosphonates alone. Oncology 76:209–211. doi:10.1159/000201931

    Article  CAS  PubMed  Google Scholar 

  54. Gore ME, Szczylik C, Porta C, Bracarda S, Bjarnason GA, Oudard S, Hariharan S, Lee SH, Haanen J, Castellano D, Vrdoljak E, Schoffski P, Mainwaring P, Nieto A, Yuan J, Bukowski R (2009) Safety and efficacy of sunitinib for metastatic renal-cell carcinoma: an expanded-access trial. Lancet Oncol 10:757–763. doi:10.1016/S1470-2045(09)70162-7

    Article  CAS  PubMed  Google Scholar 

  55. Baba M, Hong SB, Sharma N, Warren MB, Nickerson ML, Iwamatsu A, Esposito D, Gillette WK, Hopkins RF 3rd, Hartley JL, Furihata M, Oishi S, Zhen W, Burke TR Jr, Linehan WM, Schmidt LS, Zbar B (2006) Folliculin encoded by the BHD gene interacts with a binding protein, FNIP1, and AMPK, and is involved in AMPK and mTOR signaling. Proc Natl Acad Sci USA 103:15552–15557. doi:10.1073/pnas.0603781103

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  56. Choueiri TK, Plantade A, Elson P, Negrier S, Ravaud A, Oudard S, Zhou M, Rini BI, Bukowski RM, Escudier B (2008) Efficacy of sunitinib and sorafenib in metastatic papillary and chromophobe renal cell carcinoma. J Clin Oncol 26:127–131. doi:10.1200/JCO.2007.13.3223

    Article  CAS  PubMed  Google Scholar 

  57. Golshayan AR, George S, Heng DY, Elson P, Wood LS, Mekhail TM, Garcia JA, Aydin H, Zhou M, Bukowski RM, Rini BI (2009) Metastatic sarcomatoid renal cell carcinoma treated with vascular endothelial growth factor-targeted therapy. J Clin Oncol 27:235–241. doi:10.1200/JCO.2008.18.0000

    Article  PubMed  Google Scholar 

  58. Haas NB, Lin X, Manola J, Pins M, Liu G, McDermott D, Nanus D, Heath E, Wilding G, Dutcher J (2012) A phase II trial of doxorubicin and gemcitabine in renal cell carcinoma with sarcomatoid features: ECOG 8802. Med Oncol 29:761–767. doi:10.1007/s12032-011-9829-8

    Article  CAS  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

Editorial assistance in the preparation of the first draft of this manuscript was provided by Dr. Fernando Sánchez of HealthCo (Madrid, Spain), which was financially supported by the Spanish Oncology Genitourinary Group (SOGUG).

Conflict of interest

The authors declare that they do not have any conflicts of interest that could inappropriately influence their work.

Author information

Authors and Affiliations

  1. Genitourinary and Sarcoma Unit, Department of Medical Oncology, Institut Català d’Oncologia L’Hospitalet, Gran Via de L’Hospitalet, 199-203, 08908, L’Hospitalet, Barcelona, Spain

    Xavier García del Muro

  2. Hospital Parc Taulí, c/Parc Taulí, 1, 08208, Sabadell, Barcelona, Spain

    Enrique Gallardo

  3. Hospital Virgen de la Salud, Avda. de Barber, 30, 45071, Toledo, Spain

    Iciar García Carbonero

  4. Hospital de Navarra, c/Irunlarrea, 3, 31008, Pamplona, Navarra, Spain

    Nuria Laínez

  5. Hospital Universitario Reina Sofía, Avda. Menéndez Pidal, s/n, 14004, Córdoba, Spain

    María José Méndez

  6. Hospital de la Santa Creu i Sant Pau, Carrer Sant Quintí, 89, 08026, Barcelona, Spain

    Pablo Maroto

  7. Institut Català d’Oncologia L’Hospitalet, Gran Via de L’Hospitalet, 199-203, 08908, L’Hospitalatet, Barcelona, Spain

    María Ochoa de Olza

  8. Hospital Universitario San Carlos, c/Profesor Martín Lagos, s/n, 28040, Madrid, Spain

    Javier Puente

  9. Hospital Universitario La Fe, Avda. Campanar, 21, 46009, Valencia, Spain

    Gaspar Reynes

  10. Instituto Valenciano de Oncología, c/del Profesor Beltrán Bàguena, 8, 76009, Valencia, Spain

    José Rubio

  11. Hospital Universitario Miguel Servet, Pº Isabel la Católica, 1-3, 50009, Zaragoza, Spain

    Carmen Santander

  12. Hospital Vall d’Hebron, Pº Vall d’Hebron, 119-129, 08035, Barcelona, Spain

    Cristina Suárez

  13. Hospital Lucus Agusti, c/San Cibrao, s/n, 27003, Lugo, Spain

    Sergio Vázquez Estévez

  14. Hospital Universitario 12 de Octubre, Madrid, Spain

    Daniel Castellano

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  1. Xavier García del Muro
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  2. Enrique Gallardo
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  3. Iciar García Carbonero
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Correspondence to Xavier García del Muro.

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García del Muro, X., Gallardo, E., García Carbonero, I. et al. Recommendations from the Spanish Oncology Genitourinary Group for the treatment of patients with renal cell carcinoma. Cancer Chemother Pharmacol 73, 1095–1107 (2014). https://doi.org/10.1007/s00280-014-2413-0

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  • DOI: https://doi.org/10.1007/s00280-014-2413-0

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