Advances in Molecular-Targeted Therapies of Advanced Urological Cancers: Focus on Advanced Renal Cell Carcinoma

In recent years, various molecular-targeted therapies have been developed and clinically introduced. Molecular targeted therapies for advanced cancers have also been approved in the field of urology. The efficacy of various molecular-targeted drug-related therapies has been established, particularly for renal cell carcinoma (RCC). In Japan, six types of multi-kinase inhibitors, including receptor tyrosine kinases, two types of mammalian target of rapamycin inhibitors, and four types of immune checkpoint inhibitors, such as anti-programmed death-1 (PD-1), cytotoxic T-lymphocyte antigen 4, and PD-ligand 1 (L1), are currently being used for the treatment of advanced RCC. For urothelial cancers, anti-PD-1 antibodies as second-line treatment and anti-PD-L1 antibodies as maintenance therapy after chemotherapy have been approved for insurance coverage in Japan. For advanced prostate cancer, the anti-PD-1 antibody is indicated for microsatellite instability-high cases. Poly (ADP-ribose) polymerase (PARP) inhibitors can be used for patients with castration-resistant prostate cancer who are positive for BRCA gene mutations. It is important to consider patient, tumor, and drug characteristics when selecting appropriate treatments for advanced urological cancers. This article describes molecular-targeted drug therapies for advanced RCC that are frequently used in Japan.