Use of Targeted Therapies for Advanced Renal Cell Carcinoma in the Asia-Pacific Region: Opinion Statement From China, Japan, Taiwan, Korea, and Australia

• Published in: Clinical genitourinary cancer Vol. 12; no. 4; pp. 225 - 233
• Main Authors: Ye, Dingwei, Eto, Masatoshi, Chung, Jin Soo, Kimura, Go, Chang, Wen-Cheng, Chang, Yen-Hwa, Pang, See-Tong, Lee, Jae Lyun, Niu, Yuanjie, Gurney, Howard, Uemura, Hirotsugu
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2014
• Subjects: Antineoplastic Agents - therapeutic use; Australia; Carcinoma, Renal Cell - drug therapy; Carcinoma, Renal Cell - metabolism; China; Clinical practice; Drug reimbursement; Expert Testimony; Hematology, Oncology and Palliative Medicine; Humans; Japan; Kidney Neoplasms - drug therapy; Kidney Neoplasms - metabolism; Metastatic renal cell carcinoma (mRCC); Molecular Targeted Therapy; Neoplasm Proteins - antagonists & inhibitors; Prognosis; RCC guidelines; Republic of Korea; Taiwan; Tyrosine kinase inhibitor (TKI); Urology; Australia; China; Japan; Republic of Korea; Taiwan; Metastatic renal cell carcinoma (mRCC); Tyrosine kinase inhibitor (TKI); Drug reimbursement; RCC guidelines; Clinical practice
• ISSN: 1558-7673; 1938-0682
• DOI: 10.1016/j.clgc.2014.01.007

Abstract Rates of renal cell carcinoma (RCC) morbidity and mortality vary widely by geography, with increasing incidence in most countries. Interestingly, RCC incidence is significantly lower in Asian countries relative to other regions, which is attributed to environmental and genetic influences. Additionally, it has been demonstrated that different ethnic groups differ in their RCC characteristics which might lead to varied responses to therapy. In this review, physicians drawn from countries across the Asia-Pacific region—China, Japan, Taiwan, Republic of Korea, and Australia—take all available data into consideration to develop the first opinion statement on treatment of advanced RCC in the region. We have sought to determine what factors influence treatment patterns and availability of therapeutic agents in our respective countries, discussed whether these factors are fully justified or should be modified, and considered what additional efforts should be undertaken to optimize treatment outcomes in RCC. Additionally, we have addressed the limitations on treatment of RCC in the region, capturing the restrictive situations of targeted therapy use in the Asia-Pacific region, mainly because of drug availability and treatment reimbursement. Often this illustrates the gap between Western and regional or even among local guidelines, the opinions of leading physicians regarding the treatment, and the realistic access to agents for most patients. Proposals made in this document are based on clinical experience and data from clinical trials of RCC therapies in which Asian patients have been included.