Derosa Lisa, Albiges Laurence, Massard Christophe, Loriot Yohann, Fizazi Karim, Escudier Bernard
a Gustave Roussy Cancer Campus.
Expert Opin Drug Saf. 2016 Aug;15(8):1097-106. doi: 10.1080/14740338.2016.1184643. Epub 2016 May 23.
For many years, cytokines (high-dose interleukin (IL)-2 and interferon (IFN)) have been the unique available treatment options for metastatic renal cell carcinoma (mRCC) and they provided durable but modest responses at the cost of significant toxicities. To date, targeted therapies have replaced cytokine therapy due to higher response rates and more favorable toxicity profiles. The major classes of targeted therapy for mRCC include tyrosine kinase inhibitors, monoclonal antibody against vascular endothelial grow factors and inhibitors of the mammalian target of rapamycin. Thanks to these new strategies, the prognosis for the mRCC is shifting toward a chronic disease and the new challenges are the adequate treatment of adverse events (AEs) and the care for quality of life, which is crucial. Emerging immunotherapies targeting the programmed death-1 (PD-1) receptor and the programmed death ligand-1 (PD-L1) ligand have shown promising results in both efficacy and safety profiles.
Safety data published on available treatment options for renal cell carcinoma RCC are reviewed.
Various toxicities are associated with targeted agents; these toxicities are generally well tolerated but careful monitoring and appropriate management are needed to optimize the use of these strategies.
多年来,细胞因子(高剂量白细胞介素(IL)-2和干扰素(IFN))一直是转移性肾细胞癌(mRCC)唯一可用的治疗选择,它们能产生持久但适度的反应,代价是具有显著毒性。迄今为止,由于更高的缓解率和更有利的毒性特征,靶向治疗已取代细胞因子治疗。mRCC的主要靶向治疗类别包括酪氨酸激酶抑制剂、抗血管内皮生长因子单克隆抗体和雷帕霉素靶蛋白抑制剂。得益于这些新策略,mRCC的预后正朝着慢性病转变,新的挑战是妥善处理不良事件(AE)和关注生活质量,这至关重要。针对程序性死亡蛋白1(PD-1)受体和程序性死亡配体1(PD-L1)配体的新兴免疫疗法在疗效和安全性方面均显示出有前景的结果。
对已发表的肾细胞癌(RCC)现有治疗选择的安全性数据进行综述。
各种毒性与靶向药物相关;这些毒性通常耐受性良好,但需要仔细监测和适当管理,以优化这些治疗策略的使用。