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[肾细胞癌治疗的最新进展——聚焦国际指南]

[Recent advancements in the treatment of renal cell carcinoma--focus on international guidelines].

作者信息

Biró Krisztina, Küronya Zsófia

机构信息

Országos Onkológiai Intézet 1122 Budapest Ráth György u. 7-9.

出版信息

Magy Onkol. 2010 Dec;54(4):369-76. doi: 10.1556/MOnkol.54.2010.4.11.

Abstract

Recent advances in understanding the fundamental biology underlying clear-cell RCC have opened the door to a series of targeted agents, such as tyrosine kinase inhibitors (TKIs) or mTOR inhibitors. These new agents have become the standard of care in managing advanced clear-cell RCC. Choice of initial medical management in patients with metastatic clear-cell RCC should be guided by randomised studies. On the evidence available, the first-line therapy in patients with good- or intermediate-risk mRCC should be either sunitinib or pazopanib, or bevacizumab plus interferon. In selected patients sorafenib is an option, as is high-dose interleukin-2 if performance status is good. In patients with poor prognosis, temsirolimus is recommended. In cytokine refractory patients, sorafenib, when patients have progressed on a tyrosine kinase inhibitor everolimus is the agent of choice. Biró K, Küronya Z. Recent advancements in the treatment of renal cell carcinoma - focus on international guidelines.

摘要

在了解透明细胞肾细胞癌(clear-cell RCC)潜在基础生物学方面的最新进展,为一系列靶向药物打开了大门,如酪氨酸激酶抑制剂(TKIs)或mTOR抑制剂。这些新型药物已成为晚期透明细胞肾细胞癌治疗的标准方案。转移性透明细胞肾细胞癌患者初始药物治疗的选择应以随机研究为指导。根据现有证据,中高危转移性肾细胞癌(mRCC)患者的一线治疗应为舒尼替尼或帕唑帕尼,或贝伐单抗加干扰素。在特定患者中,索拉非尼是一种选择,若患者体能状态良好,高剂量白细胞介素-2也是一种选择。对于预后较差的患者,推荐使用替西罗莫司。在细胞因子难治性患者中,若患者在酪氨酸激酶抑制剂依维莫司治疗期间病情进展,索拉非尼是首选药物。比罗·K,库罗尼亚·Z。肾细胞癌治疗的最新进展——聚焦国际指南。

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