Massachusetts General Hospital Cancer Center, Boston, MA 02114, USA.
Semin Oncol. 2013 Aug;40(4):459-64. doi: 10.1053/j.seminoncol.2013.05.001.
Predictive markers of response to therapy are increasingly important in advanced renal cell carcinoma (RCC) due to the proliferation of treatment options in recent years. Different types of potential predictive markers may include clinical, toxicity-based, serum, tissue, and radiologic biomarkers. Clinical factors are commonly used in overall prognostic models of RCC but have limited utility in predicting response to therapy. Correlation between development of particular toxicities and response to therapy has been noted, such as the correlation between hypertension and response to angiogenesis-targeted therapy. Serum and tissue biomarkers will be covered in detail elsewhere, but factors such as serum lactate dehydrogenase (LDH) and circulating cytokines show promise in this regard. Finally, baseline or early treatment radiology studies may have predictive ability for longer term efficacy, with most studies to date focusing on functional imaging modalities such as positron emission tomography (PET) scans, dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI), and DCE ultrasound (US). The ultimate goal of developing predictive biomarkers is to enable rational and personalized treatment strategies for patients with advanced RCC.
由于近年来治疗选择的增多，预测治疗反应的标志物在晚期肾细胞癌（RCC）中变得越来越重要。不同类型的潜在预测标志物可能包括临床、毒性、血清、组织和影像学生物标志物。临床因素常用于 RCC 的总体预后模型，但在预测治疗反应方面的应用有限。已经注意到特定毒性的发展与治疗反应之间存在相关性，例如高血压与血管生成靶向治疗反应之间的相关性。血清和组织生物标志物将在其他地方详细介绍，但血清乳酸脱氢酶（LDH）和循环细胞因子等因素在此方面显示出希望。最后，基线或早期治疗影像学研究可能对长期疗效具有预测能力，迄今为止的大多数研究都集中在功能成像方式上，如正电子发射断层扫描（PET）扫描、动态对比增强（DCE）磁共振成像（MRI）和 DCE 超声（US）。开发预测性生物标志物的最终目标是为晚期 RCC 患者提供合理和个性化的治疗策略。
