Mammalian Target of Rapamycin Inhibitors in Clinical Practice: Case Reports of Everolimus in Renal Cell Carcinoma

Metastatic renal cell carcinoma (mRCC) is largely considered to be resistant to chemotherapy, and treatment with cytokines is associated with low response rates. Recently, therapies that target specific pathways involved in the pathogenesis of mRCC have been developed. These include vascular endothelial growth factor (VEGF)–targeted therapies (eg, sunitinib, sorafenib, bevacizumab) and mammalian target of rapamycin (mTOR) inhibitors (eg, everolimus, temsirolimus). Everolimus has been shown to have particular benefit in patients who are refractory to VEGF-targeted therapy. In this paper, the use of everolimus in two patients with mRCC is presented. Everolimus demonstrated clinical efficacy in these patients and was generally well tolerated. The case studies reported support the activity of everolimus in the treatment of mRCC in patients who had progressed on previous targeted therapy, showing the possibility of achieving extended periods of disease control.