This module covers the use of the antiangiogenic agent bevacizumab for the treatment of metastatic renal cell carcinoma (RCC). Bevacizumab first showed single-agent activity in metastatic RCC then demonstrated clinical efficacy in combination with interferon-alfa as first-line therapy. This module will review the early clinical trials with bevacizumab as well as the two large, randomized trials demonstrating a significant progression-free survival benefit with bevacizumab in combination with interferon-alfa. The toxicity profile of bevacizumab will also be reviewed. The module will then review ongoing efforts aimed at optimizing the use of bevacizumab in metastatic RCC. A randomized trial failed to show a benefit with a combination of bevacizumab plus the anti-epidermal growth factor receptor (EGFR) inhibitor erlotinib. However, clinical trials continue to evaluate the feasibility of combining bevacizumab with other targeted agents, including the multitargeted tyrosine kinase inhibitors sunitinib and sorafenib and the mammalian target of rapamycin (mTOR) inhibitors temsirolimus and everolimus.





MODULE II
Slide Deck 6 Clinically Available Targeted Therapy: Bevacizumab
Ronald M. Bukowski, MD
Emeritus Staff, Consultant
Cleveland Clinic Taussig Cancer Center
Cleveland, Ohio

References
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12. Rini BI, Halabi S, Rosenberg JE, et al. CALGB 90206: A phase III trial of bevacizumab plus interferon-alpha versus interferon-alpha monotherapy in metastatic renal cell carcinoma. 2008 ASCO Genitourinary Cancers Symposium. Abstract 350.
13. Search for Clinical Trials. A U.S. National Institutes of Health website. Available at: http://www.clinicaltrials.gov. Accessed January 16, 2008.
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15. Whorf RC, Hainsworth JD, Spigel DR, et al. Phase II study of bevacizumab and everolimus (RAD001) in the treatment of advanced renal cell carcinoma (RCC). J Clin Oncol. 2008;26(May 20 suppl): Abstract 5010.
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