American Board of Internal Medicine (ABIM) Certification Practice Exam

In high-risk disease for metastatic renal cell carcinoma, which agent is often used for treatment?

1. Bevacizumab

2. Temsirolimus

3. Axitinib

4. Sunitinib

The correct answer is: Temsirolimus

Temsirolimus is often the treatment of choice for high-risk metastatic renal cell carcinoma due to its mechanism of action and clinical efficacy in this specific patient population. It is an mTOR inhibitor that acts by blocking the mammalian target of rapamycin, a crucial pathway involved in cell growth and proliferation. In patients classified as high risk, temsirolimus has been shown to improve overall survival compared to other standard therapies. This is particularly important in this cohort, as they usually have poor prognoses and require aggressive treatment options. Other agents mentioned, such as bevacizumab, axitinib, and sunitinib, have their roles in the treatment of renal cell carcinoma, but temsirolimus is particularly favored for high-risk cases due to the clinical trial evidence supporting its use and the specific biological mechanism that targets the pathways where these tumors often have dysregulation. This makes temsirolimus a valuable option for improving outcomes in patients facing the challenges of high-risk metastatic renal cell carcinoma.