Dana-Farber Cancer Institute, Brigham & Women's Hospital, Harvard Medical School, 44 Binney Street, Boston, MA 02115, USA.
Ther Adv Med Oncol. 2010 May;2(3):209-19. doi: 10.1177/1758834010361470.
Metastatic renal cell carcinoma (RCC) poses one of the great therapeutic challenges in oncology. RCC is predominantly refractory to treatment with traditional cytotoxic chemotherapies, and until recently management options were limited to immunotherapy or palliative care. However, in the past few years we have experienced a sea change in the treatment of advanced RCC with the introduction of targeted therapies that derive their efficacy at least in part through alterations in tumor angiogenesis. The tyrosine kinase inhibitors sunitinib, pazopanib, and sorafenib, the monoclonal antibody bevacizumab (in combination with interferon-α), and the rapamycin analogs, temsirolimus and everolimus, are now approved agents in the United States for the treatment of metastatic RCC. Efforts to expand upon these successes include developing novel antiangiogenic agents, optimizing concomitant and sequential regimens, identifying predictors of response to specific treatments, and further dissecting the underlying molecular pathogenesis of RCC to reveal novel therapeutic targets.
转移性肾细胞癌 (RCC) 是肿瘤学中极具治疗挑战性的疾病之一。RCC 对传统细胞毒化疗药物具有较强的耐药性，直到最近，治疗选择仅限于免疫治疗或姑息治疗。然而，在过去几年中，随着靶向治疗药物的引入，晚期 RCC 的治疗发生了重大变化，这些药物的疗效至少部分来源于肿瘤血管生成的改变。在美国，酪氨酸激酶抑制剂舒尼替尼、帕唑帕尼和索拉非尼、单克隆抗体贝伐珠单抗（与干扰素-α联合使用）以及雷帕霉素类似物替西罗莫司和依维莫司，现已被批准用于转移性 RCC 的治疗。为了进一步扩大这些成功，研究人员正在努力开发新型抗血管生成药物、优化联合和序贯治疗方案、确定对特定治疗反应的预测因素，并进一步剖析 RCC 的潜在分子发病机制，以揭示新的治疗靶点。
