Oncology Centre, Addenbrookes Hospital, Hills Road, Cambridge, CB2 0QQ, UK.
Expert Rev Anticancer Ther. 2009 Dec;9(12):1793-805. doi: 10.1586/era.09.144.
Patients with metastatic renal cell cancer (mRCC) have traditionally had poor responses to systemic therapies. Recent developments in molecular biology have increased our understanding of the oncogenic processes and pathways in clear-cell mRCC. The development of drugs that target these pathways has expanded treatment options, improved prognosis and changed standard management of patients with clear-cell mRCC. Sunitinib, sorafenib and pazopanib (oral tyrosine kinase inhibitors) as well as everolimus and temsirolimus (mTOR inhibitors) and interferon with bevacizumab (an antibody to VEGF) have improved patient outcomes in large Phase III trials. These drugs have been incorporated into standard practice. Sunitinib has been adopted as first-line standard of care. Many agents are in development for treatment of mRCC, including axitinib in Phase III trials. We will review these treatments, their toxicities and how these targeted agents have impacted on mRCC.
患有转移性肾细胞癌（mRCC）的患者对系统治疗的反应一直很差。近年来分子生物学的发展提高了我们对 clear-cell mRCC 致癌过程和途径的认识。针对这些途径的药物的开发扩大了治疗选择，改善了预后并改变了 clear-cell mRCC 患者的标准治疗方法。舒尼替尼、索拉非尼和帕唑帕尼（口服酪氨酸激酶抑制剂）以及依维莫司和替西罗莫司（mTOR 抑制剂）以及与贝伐单抗（VEGF 抗体）联合的干扰素已在大型 III 期试验中改善了患者的结局。这些药物已被纳入标准治疗方案。舒尼替尼已被采用作为一线标准治疗药物。许多药物正在开发用于治疗 mRCC，包括 III 期试验中的阿昔替尼。我们将回顾这些治疗方法、它们的毒性以及这些靶向药物对 mRCC 的影响。
