Centre de recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM) and Institut du cancer de Montréal, Montréal, Québec, Canada; Division of Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
Centre de recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM) and Institut du cancer de Montréal, Montréal, Québec, Canada.
Clin Genitourin Cancer. 2018 Jun;16(3):176-183. doi: 10.1016/j.clgc.2018.01.003. Epub 2018 Feb 2.
To conduct a review of literature on adjuvant therapy in nonmetastatic renal-cell carcinoma (nmRCC) treated with nephrectomy and to describe the efficacy of adjuvant agents on cancer control outcomes. A review of the literature was performed in January 2018 to identify all studies evaluating adjuvant therapy in patients with nmRCC treated with nephrectomy using PubMed, Embase, Medline, and Cochrane Library databases. The following keywords were used: adjuvant therapy, renal-cell carcinoma, nonmetastatic, targeted molecular therapy, kidney cancer. The ClinicalTrials.gov website was queried to identify ongoing trials. Traditional adjuvant therapy agents consisted of interferon α, interleukin 2, autologous tumor cell vaccines, and monoclonal antibodies. None provided survival benefit. Three contemporary studies (S-TRAC, ASSURE, and PROTECT) using targeted therapy compared sunitinib to placebo (S-TRAC), sunitinib or sorafenib to placebo (ASSURE), and pazopanib to placebo (PROTECT), with controversial results. In contrast to ASSURE and PROTECT, S-TRAC demonstrated improved disease-free survival. Several trials that use checkpoint immunotherapy agents or vascular endothelial growth factor receptor tyrosine kinase inhibitors are ongoing. Many traditional therapies have shown no success as adjuvant therapy for nmRCC after nephrectomy. Targeted adjuvant therapy for nmRCC after nephrectomy showed controversial results, and its routine use is not currently endorsed.
对肾细胞癌（RCC）患者肾切除术后辅助治疗的文献进行综述，描述辅助药物对肿瘤控制结果的疗效。2018 年 1 月进行文献回顾，通过 PubMed、Embase、Medline 和 Cochrane Library 数据库，确定所有评估肾切除术后 RCC 患者辅助治疗的研究。使用以下关键词：辅助治疗、肾细胞癌、非转移性、靶向分子治疗、肾癌。查询 ClinicalTrials.gov 网站以确定正在进行的试验。传统辅助治疗药物包括干扰素α、白细胞介素 2、自体肿瘤细胞疫苗和单克隆抗体。均未提供生存获益。三项使用靶向治疗的当代研究（S-TRAC、ASSURE 和 PROTECT）将舒尼替尼与安慰剂（S-TRAC）、舒尼替尼或索拉非尼与安慰剂（ASSURE）以及帕唑帕尼与安慰剂（PROTECT）进行比较，结果存在争议。与 ASSURE 和 PROTECT 相反，S-TRAC 显示出无病生存期的改善。正在进行多项使用检查点免疫治疗药物或血管内皮生长因子受体酪氨酸激酶抑制剂的试验。许多传统疗法作为肾切除术后 RCC 的辅助治疗均未取得成功。肾切除术后 RCC 的靶向辅助治疗结果存在争议，目前不推荐常规使用。
