Chang Gung University College of Medicine, Chang Gung Memorial Hospital, Department of Dermatology, Taoyuan, Taiwan.
Expert Opin Drug Saf. 2010 May;9(3):459-70. doi: 10.1517/14740331003596349.
Targeted therapy has significantly prolonged the survival of patients with advanced renal cell carcinoma (RCC). As first-line treatment, sunitinib, temsirolimus and bevacizumab plus IFN-alpha are demonstrated to prolong progression-free survival and/or overall survival. As second-line treatment, sorafenib was active mainly for patients in whom cytokine therapy failed. Recently, second-line treatment with everolimus has been shown to benefit patients progressing through tyrosine kinase inhibitors. Meanwhile, FDA has just approved pazopanib for the treatment of patients with advanced RCC. Various toxicities were associated with these agents. These toxicities were generally well tolerated. However, a high frequency of severe skin and bone marrow toxicities has been reported in Asian countries.
We have reviewed the literature of current targeted therapeutic agents and hand-foot skin reaction (HFSR) in advanced RCC available in MEDLINE and meeting reports of ASCO, ECCO-ESMO and the 2009 Genitourinary Cancers Symposium.
Readers will know of the efficacy and safety, including HFSR, of current targeted therapy.
Careful monitoring and appropriate management of the toxicities, especially HFSR, are needed.
靶向治疗显著延长了晚期肾细胞癌（RCC）患者的生存时间。舒尼替尼、替西罗莫司和贝伐珠单抗联合 IFN-α作为一线治疗药物，已被证实可延长无进展生存期和/或总生存期。索拉非尼作为二线治疗药物，主要适用于细胞因子治疗失败的患者。最近，依维莫司二线治疗对接受酪氨酸激酶抑制剂治疗后进展的患者有益。与此同时，FDA 刚刚批准帕唑帕尼用于治疗晚期 RCC 患者。这些药物与各种毒性相关，这些毒性一般均可耐受。然而，亚洲国家报告了较高频率的严重皮肤和骨髓毒性。
我们复习了 MEDLINE 中晚期 RCC 现有靶向治疗药物和手足皮肤反应（HFSR）的文献，以及 ASCO、ECCO-ESMO 和 2009 年泌尿生殖系统癌症研讨会的会议报告。
读者将了解当前靶向治疗的疗效和安全性，包括 HFSR。
需要仔细监测和适当管理毒性，特别是 HFSR。
Zotero 插件