Poprach A, Lakomý R, Büchler T
Klin Onkol. 2017 Winter;30(Supplementum3):55-61. doi: 10.14735/amko20173S55.
Treatment of renal cell carcinoma is still palliative. Targeted therapy increases response rates and prolongs overall survival and progression-free survival compared with cytokines and chemotherapy. Checkpoint inhibitors constitute the up-date of therapeutic approaches, and anti-PD-1 antibody, one checkpoint inhibitor, is now well established as a second and/or third palliative treatment for patients with renal cell carcinoma. In this study, we present the latest data from current studies on cytokines, cancer vaccines, ipilimumab, and nivolumab. The therapeutic efficacies of combinations such as targeted therapy with immune checkpoint inhibitors and anti-CTLA-4 with anti PD-1 (-L1) have been reported in many studies. Preliminary results are encouraging but the high toxicities and elevated cost are limiting. Treatments with combinations of bevacizumab and atezolizumab, axitinib and pembrolizumab or avelumab, lenvatinib and pembrolizumab, and nivolumab and ipilimumab (results from study phase I, II, and sometimes III) are reported to be highly effective and to result in long-lasting responses with response-rates of 70-100%. So far, valid predictors for these therapies have not been forthcoming, but considerable work is being exerted in this area. Heng and Memorial Sloan Kettering Cancer Center (MSKCC) models are still being used to select patients for immunotherapy. Immunotherapy will definitely continue to play an important role in the treatment of patients with renal cell carcinoma; however, many questions remain.Key words: renal cell carcinoma - immunotherapy - checkpoint inhibitors - target therapy Supported by MH CZ - DRO (MMCI, 00209805) This work was supported by program of the Czech Ministry of Health No. P03-15-34 678A. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 16. 8. 2017Accepted: 7. 9. 2017.
肾细胞癌的治疗仍然是姑息性的。与细胞因子和化疗相比,靶向治疗提高了缓解率,延长了总生存期和无进展生存期。检查点抑制剂是治疗方法的最新进展,抗PD-1抗体作为一种检查点抑制剂,现已成为肾细胞癌患者二线和/或三线姑息治疗的常用药物。在本研究中,我们展示了当前关于细胞因子、癌症疫苗、伊匹单抗和纳武单抗研究的最新数据。许多研究报告了靶向治疗与免疫检查点抑制剂以及抗CTLA-4与抗PD-1(-L1)联合治疗的疗效。初步结果令人鼓舞,但高毒性和高成本限制了其应用。贝伐单抗与阿特珠单抗、阿昔替尼与派姆单抗或阿维鲁单抗、乐伐替尼与派姆单抗以及纳武单抗与伊匹单抗联合治疗(来自I期、II期,有时是III期研究结果)据报道具有高效性,并能产生持久反应,缓解率为70%-100%。到目前为止,尚未找到这些疗法的有效预测指标,但该领域正在进行大量研究。Heng和纪念斯隆凯特琳癌症中心(MSKCC)模型仍被用于选择免疫治疗的患者。免疫治疗肯定会继续在肾细胞癌患者的治疗中发挥重要作用;然而,仍有许多问题有待解决。关键词:肾细胞癌 - 免疫治疗 - 检查点抑制剂 - 靶向治疗 由MH CZ - DRO(MMCI,编号00209805)资助 本研究得到捷克卫生部项目编号P03-15-34 678A的支持。作者声明他们在研究中使用的药物、产品或服务方面不存在潜在利益冲突。编辑委员会声明该稿件符合ICMJE关于生物医学论文的推荐标准。提交日期:2017年8月16日 接受日期:2017年9月7日