Hospital Universitario 12 de Octubre, Madrid 28041, Spain.
Cancer Treat Rev. 2013 May;39(3):230-40. doi: 10.1016/j.ctrv.2012.04.009. Epub 2012 May 28.
Targeted agents have improved prognosis for patients with metastatic renal cell carcinoma (mRCC), and they are changing therapeutic expectations with respect to long-term clinical outcomes for these patients. However, in order to obtain the maximum clinical benefit from targeted agents, effective therapy management is essential and includes optimization of dosing and treatment duration, as well as adequate side-effect management. Sunitinib has demonstrated efficacy for the treatment of patients with mRCC and is a reference standard of care for first-line therapy. However, in clinical practice, it is difficult to determine the best treatment strategy with targeted agents due to long-term tolerability and the development of resistance. An individualized therapeutic strategy in RCC requires a comprehensive understanding of the biology of response and resistance to targeted therapy. Here we review the clinical data regarding the efficacy and safety for sunitinib and highlight the importance of therapy management, as well as the potential use of clinical biomarkers in order to maximize the clinical benefit from sunitinib treatment in patients with mRCC.
靶向药物改善了转移性肾细胞癌（mRCC）患者的预后，并且改变了人们对这些患者长期临床结果的治疗期望。然而，为了从靶向药物中获得最大的临床获益，有效的治疗管理是必不可少的，包括优化剂量和治疗持续时间，以及充分的副作用管理。舒尼替尼已被证明对 mRCC 患者的治疗有效，是一线治疗的参考标准。然而，在临床实践中，由于长期耐受性和耐药性的发展，很难确定靶向药物的最佳治疗策略。RCC 的个体化治疗策略需要全面了解对靶向治疗的反应和耐药性的生物学机制。在这里，我们回顾了关于舒尼替尼的疗效和安全性的临床数据，并强调了治疗管理的重要性，以及临床生物标志物的潜在用途，以便最大限度地提高 mRCC 患者接受舒尼替尼治疗的临床获益。
