Treatment of advanced kidney cancer (renal cell carcinoma) is very tricky, and surgery and radiation therapy cannot cure it. The vast majority of kidney cancers are clear cell cancers, for which chemotherapy is also largely ineffective, and targeted drugs are now used primarily.
In recent years, domestic and international studies have shown that molecularly targeted drugs can significantly improve response rates and prolong survival in patients with advanced metastatic kidney cancer compared with traditional cytokine therapy. Therefore, since 2006, authoritative guidelines such as the National Comprehensive Cancer Network (NCCN) and the European Association of Urology (EAU) have included molecularly targeted therapeutics – sorafenib, sunitinib, tesirimus, bevacizumab combined with interferon-α, pazopanib, everolimus, and axitinib – as the first- and second-line therapeutic use.
And the main drugs currently available in China are sunitinib, sorafenib, pazopanib, axitinib, and everolimus. However, it is not known exactly how long treatment is most appropriate, and it is not recommended that patients discontinue the drug when treatment is effective.
Many patients experience varying degrees of tumor size reduction after treatment, but the vast majority do not have complete tumor disappearance and therefore require patients to continue treatment until the tumor disappears completely, or the drug fails, the tumor increases in size, the disease progresses, or intolerable side effects occur and treatment has to be abandoned.
The above model of continuous treatment may not be ideal. Intermittent treatment modalities may be worth trying, but their effectiveness and safety have not been proven.