Vano Yann-Alexandre, Tartour Eric, Fournier Laure S, Beuselinck Benoit, Mejean Arnaud, Oudard Stephane
Department of Medical Oncology, Georges Pompidou European Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Descartes University, Paris, France.
Expert Rev Anticancer Ther. 2014 May;14(5):523-42. doi: 10.1586/14737140.2014.882773. Epub 2014 Mar 18.
The medical treatment of metastatic renal cell carcinoma (mRCC) has undergone a paradigm shift during the last decade with the approval of five drugs targeting vascular endothelial growth factor (VEGF) or its receptors (bevacizumab, sunitinib, sorafenib, pazopanib and axitinib) and of two drugs inhibiting the PI3K/AKT/mTOR (mammalian target of rapamycin) pathway (temsirolimus and everolimus). Median survival has now reached 2 years in mRCC patients receiving first-line targeted treatment. A considerable body of work was conducted on the identification of prognostic factors of survival in the earlier era of immunotherapy of mRCC. The current challenge is to pursue this work on biomarkers of prognosis for targeted therapy and, even more importantly, to identify predictive factors of response to such therapy. This review provides an overview of recent key work on prognostic and predictive factors in patients with advanced clear cell RCC treated with VEGF-targeted agents.
在过去十年中，转移性肾细胞癌（mRCC）的医学治疗发生了范式转变，有五种靶向血管内皮生长因子（VEGF）或其受体的药物（贝伐单抗、舒尼替尼、索拉非尼、帕唑帕尼和阿昔替尼）以及两种抑制PI3K/AKT/mTOR（雷帕霉素哺乳动物靶点）通路的药物（替西罗莫司和依维莫司）获得批准。接受一线靶向治疗的mRCC患者的中位生存期现已达到2年。在mRCC免疫治疗的早期阶段，人们开展了大量关于生存预后因素识别的工作。当前的挑战是在靶向治疗的预后生物标志物方面继续这项工作，更重要的是，识别对这种治疗反应的预测因素。本综述概述了近期关于接受VEGF靶向药物治疗的晚期透明细胞RCC患者预后和预测因素的关键研究。
