Ho Derek, Kim Hyung L
Cedars-Sinai Medical Center, Los Angeles, California.
Clin Adv Hematol Oncol. 2013 Dec;11(12):777-82.
Surgical resection remains the standard of care for clini- cally localized renal cell carcinoma (RCC). Nearly 1 in 4 patients will have a recurrence after surgery performed with curative intent, and stand to benefit from additional therapy. Currently, no proven adjuvant or neoadjuvant therapies are available. A number of phase 3 adjuvant therapy trials are ongoing that are evaluating small-molecule drugs approved for metastatic RCC. The outcomes of these trials may provide insights for designing future phase 3 neoadjuvant therapy trials. Several phase 2 neoadjuvant trials for RCC have recently been completed or are ongoing. These trials have established the safety and response rates associated with several agents, and will pave the way for future phase 3 trials of neoadjuvant therapy for RCC. Neoadjuvant therapies may be useful for decreasing the risk of recurrence after surgery, maximiz- ing nephron sparing, and evaluating molecular effects of targeted therapies in human tumors.
手术切除仍然是临床局限性肾细胞癌（RCC）的标准治疗方法。近四分之一的患者在进行根治性手术后会复发，可能从额外治疗中获益。目前，尚无经证实的辅助或新辅助治疗方法。多项3期辅助治疗试验正在进行，这些试验正在评估已被批准用于转移性RCC的小分子药物。这些试验的结果可能为设计未来的3期新辅助治疗试验提供见解。最近已经完成或正在进行几项针对RCC的2期新辅助试验。这些试验已经确定了几种药物的安全性和缓解率，并将为未来RCC新辅助治疗的3期试验铺平道路。新辅助治疗可能有助于降低手术后复发的风险，最大限度地保留肾单位，并评估靶向治疗在人类肿瘤中的分子效应。
