Youssef Ramy F, Cost Nicholas G, Darwish Oussama M, Margulis Vitaly
Division of Urologic Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Arab J Urol. 2012 Jun;10(2):110-7. doi: 10.1016/j.aju.2012.02.005. Epub 2012 Apr 9.
Increased knowledge about the molecular pathways involved in tumorigenesis has led to the discovery of new prognostic molecular markers and development of novel targeted therapies for renal cell carcinoma (RCC). In this review we describe the prognostic markers of RCC and highlight the areas of recent discovery with a focus on the mammalian target of rapamycin (mTOR) pathway.
We reviewed previous reports, using PubMed with the search terms 'renal cell carcinoma', 'molecular markers', 'prognosis', 'outcomes' and 'mammalian target of rapamycin pathway' published in the last two decades. We created a library of 100 references and focused on presenting the recent advances in the field.
Growing evidence suggests that mTOR deregulation is associated with many types of human cancer, including RCC. Consequently, temsirolimus and everolimus, which target mTOR, are approved for treating advanced RCC. There is a demand to integrate clinical, pathological and molecular markers into accurate prognostic models to provide patients with the most personalised cancer care possible.
The mTOR pathway is highly implicated in RCC tumorigenesis and progression, and its constituents might represent a promising prognostic tool and target for treating RCC. Combining newly discovered molecular markers with classic clinicopathological prognostics might potentially improve the management of RCC.
对肿瘤发生所涉及分子途径的认识不断增加，促使人们发现了新的预后分子标志物，并开发出针对肾细胞癌（RCC）的新型靶向治疗方法。在本综述中，我们描述了RCC的预后标志物，并重点介绍了近期的发现领域，特别关注雷帕霉素哺乳动物靶点（mTOR）途径。
我们回顾了过去二十年发表在PubMed上的先前报告，搜索词为“肾细胞癌”、“分子标志物”、“预后”、“结局”和“雷帕霉素哺乳动物靶点途径”。我们建立了一个包含100篇参考文献的文库，并专注于展示该领域的最新进展。
越来越多的证据表明，mTOR失调与包括RCC在内的多种人类癌症相关。因此，靶向mTOR的替西罗莫司和依维莫司已被批准用于治疗晚期RCC。需要将临床、病理和分子标志物整合到准确的预后模型中，以便为患者提供尽可能个性化的癌症治疗。
mTOR途径与RCC的肿瘤发生和进展密切相关，其组成成分可能是一种有前景的预后工具和RCC治疗靶点。将新发现的分子标志物与经典的临床病理预后指标相结合，可能会改善RCC的治疗管理。
