Stanculeanu D L, Lazescu A, Zob D D, Bunghez R, Anghel R, Poteca T D
Institute of Oncology, Bucharest, Romania.
J Med Life. 2016 Apr-Jun;9(2):193-8.
Renal cell carcinoma (RCC) represents 3% of all cancers, with the highest incidence occurring in the most developed countries and representing the seventh most common cancer in men and the ninth most common cancer in women. The understanding of the tumor molecular biology and the discovery of new drugs that target molecular pathways have increased the arsenal against advanced renal cell carcinoma and improved the outcomes in the patients suffering from these affections. Studying the molecular signaling that controls the tumor growth and the progression has led to the development of molecular therapies targeting the vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTOR) pathways, resulting in a significant improvement in the overall survival and quality of life. Sunitinib represents an inhibitor of VEGFR 1-3, c-kit, FLT-3 and PDGFR. We present the case of a patient with metastatic clear cell RCC with a treatment effect following sequential VEGF and mTOR inhibitor treatment. Under sunitinib treatment, the patient had a progression free survival (PFS) of approximately 9 months, similar to the PFS observed in clinical trials. Sunitinib was well tolerated by this patient. Temsirolimus, an mTOR inhibitor, is currently only approved for the first-line treatment of mRCC patients with poor prognosis. This study analyzes a treatment effect of second line temsirolimus in a patient with metastatic renal cell carcinoma (mRCC).
肾细胞癌（RCC）占所有癌症的3%，在最发达国家发病率最高，是男性中第七大常见癌症，女性中第九大常见癌症。对肿瘤分子生物学的理解以及针对分子途径的新药的发现，增加了对抗晚期肾细胞癌的手段，并改善了患有这些疾病的患者的治疗效果。研究控制肿瘤生长和进展的分子信号通路，导致了针对血管内皮生长因子（VEGF）和雷帕霉素哺乳动物靶点（mTOR）途径的分子疗法的发展，从而显著提高了总生存率和生活质量。舒尼替尼是一种VEGFR 1-3、c-kit、FLT-3和PDGFR的抑制剂。我们报告了一例转移性透明细胞肾细胞癌患者在序贯使用VEGF和mTOR抑制剂治疗后产生治疗效果的病例。在舒尼替尼治疗下，该患者的无进展生存期（PFS）约为9个月，与临床试验中观察到的PFS相似。该患者对舒尼替尼耐受性良好。替西罗莫司是一种mTOR抑制剂，目前仅被批准用于一线治疗预后不良的转移性肾细胞癌（mRCC）患者。本研究分析了二线替西罗莫司对一名转移性肾细胞癌（mRCC）患者的治疗效果。
