Grünwald V
Schwerpunkt Interdisziplinäre Uroonkologie am Westdeutschen Tumorzentrum, Universitätsklinikum Essen, Hufelandstr. 55, 45147, Essen, Deutschland.
Urologe A. 2018 Nov;57(11):1326-1333. doi: 10.1007/s00120-018-0791-3.
The introduction of immunotherapy into the therapeutic algorithm of metastatic renal cell carcinoma (mRCC) represents the most recent expansion of the therapy landscape. This provides a new therapeutic axis in addition to targeted therapies. At the same time, the development of new tyrosine kinase inhibitors (TKIs) has led to an improvement in the effectiveness of targeted therapies. Cabozantinib and tivozanib are two new first-line options that redefine the existing therapy algorithm. The importance of the checkpoint blockade in the first line is clinically undisputed; however, approval of the immune combination ipilimumab + nivolumab has not yet been granted. An important task now is to offer risk-adapted therapy in order to optimally balance efficacy and risks of systemic therapy, thereby ensuring the best possible individual therapy.
免疫疗法引入转移性肾细胞癌（mRCC）的治疗方案代表了治疗领域的最新扩展。这在靶向治疗之外提供了一个新的治疗轴。同时，新型酪氨酸激酶抑制剂（TKIs）的开发提高了靶向治疗的有效性。卡博替尼和替沃扎尼是重新定义现有治疗方案的两种新的一线选择。一线检查点阻断的重要性在临床上是无可争议的；然而，免疫联合方案伊匹木单抗+纳武单抗尚未获批。现在的一项重要任务是提供风险适应性治疗，以便在全身治疗的疗效和风险之间实现最佳平衡，从而确保尽可能最佳的个体化治疗。
