Table 1.

Front-Line Therapies Targeting VEGF and mTOR Pathways in mRCC

Drug	Advantages	Disadvantages
Sorafenib	Improves PFS (5.5 vs 2.8 months)	Less tolerable than sunitinib or pazopanib
Sunitinib	Improves PFS (11 vs 5 months) Good ORR 47%	Lack of OS benefit
Temsirolimus	Improves OS (10. 9 vs 7.3 months) Good option for intermediate- to poor-risk mRCC and non-clear cell histology	Weekly IV dosing Lack of objective responses by RECIST criteria
Bevacizumab + IFN-α	Improves PFS (10.2 vs 5.4 months)	IFN-α is not well-tolerated No OS benefit
Pazopanib	Improves PFS (9.2 vs 4.2 months) Noninferior to sunitinib (COMPARZ)	Higher incidence of hepatotoxicity
Cabozantinib	Improves PFS (8.6 vs 5.3 months)	Not an option for good-risk mRCC

Abbreviations: VEGF, vascular endothelial growth factor; mTOR, mammalian target of rapamycin; mRCC, metastatic renal cell carcinoma; OS, overall survival; PFS, progression-free survival; ORR, overall response rate; IFN-α, interferon-alpha.