Medical Oncology, I.R.C.C.S. San Matteo University Hospital Foundation, Piazzale C. Golgi 19, I-27100 Pavia, Italy.
Crit Rev Oncol Hematol. 2012 Jun;82(3):323-37. doi: 10.1016/j.critrevonc.2011.06.001. Epub 2011 Jul 5.
The introduction of novel anti-angiogenic therapies has greatly improved the outcome of patients with metastatic renal cell carcinoma (mRCC). The use of these therapies in combination or sequentially is proposed to provide greater efficacy. We have reviewed completed and ongoing clinical trials in mRCC that have reported efficacy and/or safety data of novel therapies used in combination or sequentially. Bevacizumab appears to be a useful partner when combined with interferon (IFN), while controversial results have been reported when combined with temsirolimus and everolimus. Other combinations appear to have unacceptable tolerability or require dose or schedule optimization. Sequencing data provide a clear indication that multiple lines of treatment may extend survival. The 'ideal' sequence, however, is still unknown. In conclusion, novel therapies used in combination or sequentially have potential to provide optimised treatment and patient outcomes in mRCC. The results from ongoing/planned trials are expected to help shape future therapy.
新型抗血管生成疗法的引入极大地改善了转移性肾细胞癌（mRCC）患者的预后。这些疗法的联合或序贯应用被认为能提高疗效。我们对已完成和正在进行的 mRCC 临床试验进行了回顾，这些试验报告了联合或序贯使用新型疗法的疗效和/或安全性数据。贝伐珠单抗与干扰素（IFN）联合应用似乎是一种有效的联合用药，而与替西罗莫司和依维莫司联合应用则报告了有争议的结果。其他联合用药的耐受性似乎无法接受，或需要优化剂量或方案。序贯治疗数据清楚地表明，多种治疗方法可能延长生存期。然而，“理想”的序贯治疗方案仍不清楚。总之，新型疗法的联合或序贯应用可能为 mRCC 提供优化的治疗和患者预后。正在进行/计划中的试验结果有望为未来的治疗提供帮助。
