Bodrogi István
Országos Onkológiai Intézet, Budapest.
Magy Onkol. 2007;51(2):145-53. Epub 2007 Jul 29.
Sporadic renal cell carcinomas are characterized by EGFR (HER-1) and EGFR-2 (HER-2) expression, however, signal transduction inhibitors of this pathway were clinically ineffective. Clear cell renal cell cancer is hormone-, irradiation- and chemotherapy resistant with moderate sensitivity to immunotherapy. The only clinically effective class of agents in case of this tumor type was proved to be the angiosuppressive agents. In 2005 FDA approved sorafenib for the first line treatment while in 2006 sunitinib for second line treatment in the cytokine resistant medium-risk renal cell carcinoma. This was followed by the European approval of both agents for second line treatment of renal cell cancer. Sunitinib was approved for first line treatment of renal cell cancer in Europe based on a phase III trial comparing it to interferon. Temsirolimus obtained its approval for the treatment of high risk renal cell cancer patients in 2007. Last but not least, FDA approval is on the way in case of bevacizumab as well to treat renal cell cancer. Based on the data demonstrated on the ASCO'2007, various modalities have to be developed for various stages of progression of clear cell renal cell cancer.
散发性肾细胞癌的特征在于表皮生长因子受体（HER-1）和表皮生长因子受体-2（HER-2）的表达，然而，该信号转导途径的抑制剂在临床上无效。透明细胞肾细胞癌对激素、放疗和化疗具有抗性，对免疫疗法具有中等敏感性。对于这种肿瘤类型，唯一被证明在临床上有效的药物类别是血管抑制药物。2005年，美国食品药品监督管理局（FDA）批准索拉非尼用于一线治疗，2006年批准舒尼替尼用于细胞因子抵抗的中危肾细胞癌的二线治疗。随后，这两种药物均获欧洲批准用于肾细胞癌的二线治疗。基于一项将舒尼替尼与干扰素进行比较的III期试验，舒尼替尼在欧洲被批准用于肾细胞癌的一线治疗。替西罗莫司于2007年获批用于治疗高危肾细胞癌患者。最后同样重要的是，贝伐单抗治疗肾细胞癌也即将获得FDA批准。基于2007年美国临床肿瘤学会（ASCO）展示的数据，对于透明细胞肾细胞癌进展的不同阶段，必须开发各种治疗方式。
