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Figure 7 |
Therapeutic evolution and survival outcome of metastatic clear cell renal cell carcinoma through
the four different eras. a
| Before 2005, two drugs were available to treat renal cell carcinoma (RCC; with a median
survival of ~15 months). This so-called dark age of treatments was followed by the modern age (2005–2014),
which saw seven additional regimens gain approval (increasing the median survival to ~30 months). Currently,
the golden age has already witnessed the introduction of three drugs, with more anticipated over the next decade.
b
| These advances promise to be translated to a significant number of patients (~50%), achieving durable remissions
under active surveillance by 2025 with a median survival of ~5 years. The ultimate goal of the future diamond age of
b
Overall survival (%)
100
90
70
50
40
30
20
10
0
3
10
1
5
Time (years)
0
80
60
4
2
6
8
7
9
Dark age (before 2005)
Modern age (2005–2014)
Golden age (2015–2025)
Diamond age (aȎer 2025)
•
New drugs
•
Drug combinations
•
Drug sequences
•
Vaccinations
•
Improved local management
•
Precision therapy
Diamond age
1992 2005 2006 2007 2008 2009 2010 2012 2015 2016 2025
Dark age
Modern age
Golden age
Sorafenib
Everolimus
plus interferon-
Pazopanib
Axitinib
Lenvatinib
Nivolumab
Interferon-
α
Sunitinib
Hsieh JJ, et l. Nat Rev Dis Prim 2017;3:17009
TARGETED THERAPIES HAVE IMPROVED
OS IN mRCC
The “Golden Age”