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. 2012 Feb 15:2:13.
doi: 10.3389/fonc.2012.00013. eCollection 2012.

Third generation tyrosine kinase inhibitors and their development in advanced renal cell carcinoma

Ronald M Bukowski  1
Affiliations

Third generation tyrosine kinase inhibitors and their development in advanced renal cell carcinoma

Ronald M Bukowski. Front Oncol. .

Abstract

Angiogenesis in general and the vascular endothelial growth factor (VEGF) signaling axis in particular is a validated target in renal cell carcinoma (RCC). Clear-cell carcinoma of the kidney is now recognized as a malignancy that is sensitive to inhibitors of the VEGF pathway. Treatment options for patients with metastatic renal cell carcinoma have evolved in dramatic fashion over the past 6 years, and a new paradigm has developed. The cytokines interferon-α and interleukin-2 were previously utilized for therapy, but since December 2005, six new agents have been approved in the United States for the treatment of advanced RCC. Two are tyrosine kinase inhibitors (TKI's) including sunitinib and recently pazopanib, and the multikinase inhibitor sorafenib. The current review examines the evolving data with the next generation of TKI's, axitinib and tivozanib being developed for the treatment of advanced RCC. These agents were synthesized to provide increased target specificity and enhanced target inhibition. The preclinical and clinical data are examined, an overview of the development of these TKI's is provided, and discussion plus speculation concerning their potential roles as RCC therapy is provided.

Keywords: renal cell carcinoma; tyrosine kinase inhibitors.

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Figures

Figure 1
Figure 1
Molecular structures and chemical data for two third generation tyrosine kinase inhibitors, axitinib (Hu-Lowe et al., 2008), and tivozanib (Gupta and Fishman, 2011).
Figure 2
Figure 2
Phase 3 pivotal trial (AXIS and TIVO-1) designs for studies of axitinib or tivozanib vs sorafenib.
See this image and copyright information in PMC

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