Medical Oncology Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Parc Taulí, 1, 08208, Sabadell, Spain.
Medical Oncology Department, Maimonides Institute of Biomedical Research (IMIBIC), Reina Sofía Hospital, University of Córdoba, Córdoba, Spain.
Clin Transl Oncol. 2018 Jan;20(1):47-56. doi: 10.1007/s12094-017-1765-4. Epub 2017 Nov 13.
The goal of this article is to provide recommendations about the management of kidney cancer. Based on pathologic and molecular features, several kidney cancer variants were described. Nephron-sparing techniques are the gold standard of localized disease. After a randomized trial, sunitinib could be considered in adjuvant treatment in high-risk patients. Patients with advanced disease constitute a heterogeneous population. Prognostic classification should be considered. Both sunitinib and pazopanib are the standard options for first-line systemic therapy in advanced renal cell carcinoma. Based on the results of two randomized trials, both nivolumab and cabozantinib should be considered the standard for second and further lines of therapy. Response evaluation for present therapies is a challenge.
本文旨在为肾癌的治疗提供建议。根据病理和分子特征,可将肾癌分为多种亚型。保留肾单位手术是局限性疾病的金标准。基于一项随机试验,舒尼替尼可作为高危患者的辅助治疗。晚期疾病患者构成异质性人群,应考虑预后分类。舒尼替尼和帕唑帕尼是晚期肾细胞癌一线系统治疗的标准选择。基于两项随机试验结果,纳武利尤单抗和卡博替尼都应作为二线及后线治疗的标准方案。目前的治疗方法疗效评价是一个挑战。