There are now a number of licensed drug options available for the treatment of advanced renal cell carcinoma (RCC). Many of them have data supporting their use as first- and second-line treatments. However, it is still not clear what sequence these drugs should be used in, especially as data coming out of clinical trials may change the order in which the drugs are administered.

RCC is somewhat unique in that the target for stopping its growth is well known. Hence, several treatments have been developed to block vascular endothelial growth factor (VEGF) to halt the growth and spread of the cancer.

However, most people eventually develop resistance VEGF drugs, and they stop working. A new strategy is needed, such as switching to a second-generation VEGF inhibitor with a different mechanism of action, using a combination of VEGF inhibitors with different mechanisms of action, or using immunotherapy.

At the 2017 Hematology/Oncology Pharmacy Association annual meeting, Dr Mohs, a clinical oncology pharmacist at Sanford Medical Center Fargo, in North Dakota, USA, along with Dr Rebecca Greene and Dr Anne Spengler discussed the options for treating advanced RCC.

Read the article in Clinical Oncology News here