Departments of Medicine and Urology, University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, Chapel Hill, NC 27599, USA.
Urol Oncol. 2010 Jan-Feb;28(1):69-73. doi: 10.1016/j.urolonc.2009.02.001.
Renal cell carcinoma is a potentially devastating cancer, and when metastatic, remains incurable with currently available systemic therapy. Surgical nephrectomy remains the only proven modality which can offer curative options for patients with resectable disease. Further, cytoreductive nephrectomy continues to play a role in the metastatic disease setting. The use of targeted therapy as an adjunct to surgical resection is beginning to be explored in both of these clinical scenarios. Immediate questions regarding preoperative treatment with VEGF pathway targeted therapy include issues surrounding the safety of these agents in use in the perioperative time period, the expectations for response in the primary tumor, the optimal duration of therapy, and the clinical settings in which this therapy may be most beneficial. This review will discuss the current experience with neoadjuvant or preoperative therapy in locally advanced or metastatic renal cell carcinoma and will overview the challenges and opportunities which lie ahead for this form of multimodality therapy.
肾细胞癌是一种潜在的破坏性癌症，当转移时，目前可用的全身治疗仍然无法治愈。手术肾切除术仍然是唯一被证实的方法，可以为可切除疾病的患者提供治愈的选择。此外，细胞减灭性肾切除术在转移性疾病的治疗中仍然发挥着作用。靶向治疗作为手术切除的辅助手段，在这两种临床情况下的应用都开始得到探索。关于在围手术期使用血管内皮生长因子通路靶向治疗的术前治疗的直接问题包括：这些药物在围手术期使用的安全性问题、对原发性肿瘤反应的预期、最佳治疗持续时间以及这种治疗可能最有益的临床环境。这篇综述将讨论局部晚期或转移性肾细胞癌的新辅助或术前治疗的现有经验，并概述这种多模式治疗的挑战和机遇。
