This article in the Drug and Therapeutics Bulletin (DTB) reviews the evidence on the efficacy, tolerability and cost-effectiveness of tyrosine kinase inhibitors (sunitinib, sorafenib, and pazopanib) in the treatment of renal cell carcinoma.

The review notes that standard drug treatments such as cytokines (interleukin-2 or interferon-alfa), ‘mammalian target of rapamycin’ inhibitors (temsirolimus or everolimus) and antibodies against growth factors that are implicated in development of the carcinomas (bevacizumab) have had limited efficacy and extensive unwanted effects. However, the tyrosine kinase inhibitors offer only a few added months of life compared to the standard therapies options; they have important cardiovascular, gastrointestinal and haematological toxicities that require close monitoring, there are insufficient data on quality of life; and they are very expensive. For these reasons, the review concludes that it cannot recommend their use in patients with renal cell carcinoma outside a research context.