[en] Carcinoma, Renal Cell/drug therapy/metabolism/secondary ; Evidence-Based Medicine ; Humans ; Immunosuppressive Agents/adverse effects/pharmacology/therapeutic use ; Intracellular Signaling Peptides and Proteins/metabolism ; Kidney Neoplasms/drug therapy/metabolism/secondary ; Protein-Serine-Threonine Kinases/metabolism ; Randomized Controlled Trials as Topic ; Sirolimus/adverse effects/analogs & derivatives/pharmacology/therapeutic use ; Treatment Outcome
[en] Renal cell carcinoma accounts for 3% of all malignant tumours. Until a few years ago, immunotherapy (interferon and/or interleukin-2) was the only approved option in the metastatic setting. Better knowledge of renal cell cancer biology drew attention on the fundamental role of angiogenesis. Several strategies targeting angiogenesis have been developed including VEGF ("Vascular Endothelial Growth Factor") and VEGFR inhibitors. They are now the usual treatment in first line. Until recently, no standard treatment was available after failure under or after these inhibitors. Everolimus (Afinitor), a mTOR ("mammalian Target Of Rapamycin") inhibitor, has just been validated and reimbursed in this setting. In this paper, we will review the mechanism of action and the clinical results of everolimus.