Sosman Jeffrey A
Vanderbilt-Ingram Cancer Center, 777 Preston Research Building, Nashville, TN 37232, USA.
Expert Rev Anticancer Ther. 2008 Mar;8(3):481-90. doi: 10.1586/14737140.8.3.481.
The emergence of targeted therapies for advanced renal cell carcinoma has been a dramatic turning point in improving outcomes for the majority of patients with this disease. In study populations comprising primarily good- and intermediate-risk patients with clear cell renal cell carcinoma and prior nephrectomy, prolonged progression-free survival was demonstrated for three angiogenesis-targeted agents: sunitinib (compared with interferon [IFN]), bevacizumab plus IFN (vs IFN alone) and sorafenib (vs placebo in cytokine-refractory patients). As a first-line treatment for patients with multiple poor-risk factors, temsirolimus, which inhibits mTOR, has improved not only progression-free survival compared with IFN but, more importantly, overall survival. Further studies are needed to determine whether combinations and/or sequencing of these targeted agents can further improve outcomes.
晚期肾细胞癌靶向治疗的出现，是改善大多数此类疾病患者预后的一个重大转折点。在主要由低危和中危透明细胞肾细胞癌且之前已行肾切除术的患者组成的研究人群中，三种血管生成靶向药物显示出无进展生存期延长：舒尼替尼（与干扰素[IFN]相比）、贝伐单抗加IFN（与单用IFN相比）和索拉非尼（与细胞因子难治性患者中的安慰剂相比）。作为具有多种高危因素患者的一线治疗，抑制mTOR的替西罗莫司不仅与IFN相比改善了无进展生存期，更重要的是改善了总生存期。需要进一步研究以确定这些靶向药物的联合使用和/或序贯使用是否能进一步改善预后。
