Courtney Kevin D, Choueiri Toni K
Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, 44 Binney Street, Boston, MA 02115, USA.
Curr Oncol Rep. 2009 May;11(3):218-26. doi: 10.1007/s11912-009-0031-5.
The past few years have seen dramatic advances in the treatment of metastatic renal cell carcinoma (RCC). Dissection of the molecular pathways that regulate proliferation, apoptosis, and angiogenesis has led to the development of targeted therapies such as the receptor tyrosine kinase inhibitors sunitinib and sorafenib, the anti-vascular endothelial growth factor antibody bevacizumab, and a class of rapamycin analogues including everolimus and temsirolimus. Each of these agents has demonstrated clinical efficacy in patients with metastatic RCC. The challenge before us is to expand on these successes by identifying which patients will best respond to these targeted therapies, optimizing the proper combination or sequence of available therapies, developing agents with improved side effect profiles, and identifying novel therapeutic targets to expand our armamentarium in the treatment of RCC.
在过去几年中，转移性肾细胞癌（RCC）的治疗取得了显著进展。对调节细胞增殖、凋亡和血管生成的分子途径的剖析，促使了靶向治疗的发展，如受体酪氨酸激酶抑制剂舒尼替尼和索拉非尼、抗血管内皮生长因子抗体贝伐单抗，以及包括依维莫司和替西罗莫司在内的一类雷帕霉素类似物。这些药物中的每一种都已在转移性RCC患者中显示出临床疗效。我们面临的挑战是，通过确定哪些患者对这些靶向治疗反应最佳、优化现有治疗的合适组合或顺序、开发副作用更小的药物，以及确定新的治疗靶点来扩充我们治疗RCC的手段，从而在这些成功的基础上更进一步。
