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hypoglycemia, and required urgent hepatic arterial embolization. He remained asymptomatic until imaging results revealed disease progression in October 2009. He was then enrolled in a phase II trial of bevacizumab and temsirolimus ( ClinicalTrials

–naïve patients with mRCC, “optimal” first-line options include sunitinib, pazopanib, the combination of bevacizumab and interferon-alpha, and temsirolimus (in poor-risk RCC only). These recommendations are all based on significantly improving efficacy over the

and related compounds (e.g., everolimus, temsirolimus) that inhibit the serine/threonine kinase activity of mTOR in the mTORC1 compex, 65 Temsirolimus reduces growth of HNSCC cell lines in xenograft models, 66 and everolimus inhibits tumor growth in

-779, a novel macrolide anti-tumor agent, on growth of human tumor cells in vitro and in nude mouse xenografts in vivo [abstract] . Proc Am Assoc Cancer Res 1999 ; 40 : Abstract 301 . 39 Hudes G Carducci M Tomczak P . Temsirolimus

translation. 56 Multiple studies are examining the role of mTOR inhibition in sarcomas. The Sidney Kimmel Comprehensive Cancer Center is conducting a phase I/II study to evaluate the safety and efficacy of temsirolimus and liposomal doxorubicin in patients

favorable side effect profile. 49 , 52 Six different targeted therapy medications have been approved by the FDA for the treatment of patients with advanced RCC: sunitinib, sorafenib, pazopanib, temsirolimus, everolimus, and bevacizumab combined with

as sorafenib and vemurafenib, have been associated with hand-foot skin reaction (HFSR), 5 and the newer BRAF inhibitor regorafenib “has some pretty dramatic skin manifestations,” noted Dr. Burtness. mTOR inhibitors, such as temsirolimus and

bevacizumab, high-dose interleukin-2 for selected patients, and temsirolimus. Ipilimumab plus nivolumab was just added to the NCCN Guidelines as a category 2A recommendation for subsequent therapy in patients with metastatic RCC. Best supportive care is

have been implicated as critical pathways in NET growth. In a phase II trial, 36 heavily pretreated patients with disease progression (21 carcinoid, 15 pancNET) were treated with 25 mg intravenous weekly doses of the mTOR inhibitor temsirolimus, with an

default standard for comparison in first-line trials that led to the approval of 3 targeted agents in RCC, 6 , 9 , 24 including the phase III trials of sunitinib and temsirolimus. Because of the improved progression-free survival seen in the experimental