David Kevin A, Milowsky Matthew I, Nanus David M
Department of Medicine, Weill Medical College of Cornell University and New York Presbyterian Hospital, NY 10021, USA.
Clin Genitourin Cancer. 2006 Mar;4(4):263-8. doi: 10.3816/CGC.2006.n.005.
Clear-cell carcinoma is the most common histopathologic subtype of kidney tumors. Consequently, clinical trials for advanced-stage kidney cancer have focused on patients with clear-cell carcinoma and not on the less common subtypes, including papillary, chromophobe, collecting-duct carcinoma, and sarcomatoid-variant tumors. Whereas immunotherapy has constituted the standard treatment for patients with clear-cell renal cell carcinoma (RCC), it does not appear to have activity in the management of patients with other histologic subtypes. Novel therapies, including those targeting the vascular endothelial growth factor pathway, have recently demonstrated significant activity in clear-cell RCC. Historically, chemotherapy has shown limited activity in advanced-stage RCC; however, clinical trials to date have failed to individualize treatment based on histologic subtype. In this article, we will review the literature and present our experience with the use of chemotherapy in patients with non-clear-cell kidney cancer by histologic subtype.
透明细胞癌是肾肿瘤最常见的组织病理学亚型。因此，晚期肾癌的临床试验主要针对透明细胞癌患者，而非针对包括乳头状癌、嫌色细胞癌、集合管癌和肉瘤样变异肿瘤等不太常见的亚型。虽然免疫疗法已成为透明细胞肾细胞癌（RCC）患者的标准治疗方法，但它似乎对其他组织学亚型患者的治疗无效。包括那些靶向血管内皮生长因子途径的新型疗法，最近在透明细胞RCC中显示出显著疗效。从历史上看，化疗在晚期RCC中的疗效有限；然而，迄今为止的临床试验未能根据组织学亚型进行个体化治疗。在本文中，我们将回顾文献，并介绍我们在按组织学亚型对非透明细胞肾癌患者使用化疗方面的经验。
