Department of Medicine, Division of Hematology and Oncology, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA.
Curr Opin Oncol. 2010 May;22(3):250-6. doi: 10.1097/CCO.0b013e328337a5d2.
The review will examine the recent advances in our understanding of the genetic and molecular events that shape this cancer, and overview the emerging targeted therapies that have altered the landscape for renal cell carcinoma (RCC) patients.
The incidence of RCC continues to rise, making it the 7th and 8th most common cancer among men and women in the US, respectively. Von Hippel-Lindau (VHL) gene loss is an important factor in the development of clear cell RCC, however: loss of VHL can result in tumors which express both HIF1 and HIF2, or HIF2 alone, correlating with distinct pathway activities. Invasive tumors demonstrating loss of VHL consistently demonstrate additional genetic changes, which appear to be essential for tumor progression. Targeted therapies have demonstrated improvements in overall survival. New ways to radiographically measure the tumor response to these treatments may provide additional information about a drug's activity in an individual patient. Vascular endothelial growth factor receptor tyrosine kinase inhibitors are still being investigated in the adjuvant setting.
The field of RCC biology continues to rapidly change. As new targeted strategies to control this cancer evolve, so do both the clinical strategies, and the strategies to measure response and predict outcome.
本文将探讨我们对导致肾癌发生的遗传和分子事件的最新认识，并概述新兴的靶向治疗方法，这些方法改变了肾癌患者的治疗前景。
在美国，肾癌的发病率持续上升，分别成为男性和女性中第 7 位和第 8 位最常见的癌症。VHL 基因缺失是透明细胞癌发生的重要因素，然而：VHL 的缺失会导致同时表达 HIF1 和 HIF2 或仅表达 HIF2 的肿瘤，与不同的通路活性相关。表现出 VHL 缺失的侵袭性肿瘤始终表现出其他遗传改变，这些改变似乎对肿瘤进展至关重要。靶向治疗已显示出总体生存率的提高。新的影像学方法来测量肿瘤对这些治疗的反应可能为个体患者的药物活性提供额外信息。血管内皮生长因子受体酪氨酸激酶抑制剂仍在辅助治疗中进行研究。
肾癌生物学领域的研究在不断发展。随着控制这种癌症的新靶向策略的不断发展，临床策略以及评估反应和预测预后的策略也在不断发展。
