Coinu Andrea, Petrelli Fausto, Barni Sandro
a Oncology Department - Medical Oncology Unit , Azienda ospedaliera Treviglio , Treviglio , BG , Italy.
Expert Rev Anticancer Ther. 2016;16(1):33-43. doi: 10.1586/14737140.2016.1109454. Epub 2015 Nov 4.
Poor-risk metastatic renal cell carcinoma (RCC) includes a subgroup of patients with unfavorable prognosis, according to both the Motzer and Heng criteria. Overall, owing to the poor prognosis of these patients, the approach is still a challenge for the first and subsequent lines of treatment, particularly for rare histologies other than clear cell renal cell carcinoma. In this review, we investigated the present treatment option of poor-risk metastatic RCC. Areas covered are data with first and further line of therapy with mTOR inhibitors and other agents but without cytoreductive nephrectomy or rare histologies. The current data on systemic therapy in poor-risk metastatic RCC maintain temsirolimus as the preferred first-line therapy. New agents targeting immune checkpoints are being developed in clinical trials.
根据莫泽尔和亨氏标准，预后不良的转移性肾细胞癌（RCC）包括一组预后不佳的患者。总体而言，由于这些患者预后较差，无论是一线治疗还是后续治疗方案仍然是一项挑战，尤其是对于非透明细胞肾细胞癌的罕见组织学类型。在本综述中，我们研究了预后不良的转移性RCC的当前治疗选择。涵盖的领域是关于mTOR抑制剂和其他药物的一线及后续治疗的数据，但不包括减瘤性肾切除术或罕见组织学类型。目前关于预后不良的转移性RCC全身治疗的数据表明，替西罗莫司仍是首选的一线治疗药物。针对免疫检查点的新型药物正在临床试验中研发。
