Division of Hematology and Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Cancer. 2019 Dec 1;125(23):4148-4157. doi: 10.1002/cncr.32361. Epub 2019 Sep 18.
Advanced renal cell carcinoma has historically carried a poor prognosis with very limited treatment options. However, in recent years, the treatment landscape has changed drastically, with many new therapeutic options and improved survival for patients. Novel treatments consist of molecularly targeted agents against the vascular endothelial growth factor (VEGF) pathway as well as the immune checkpoint inhibitors, which stimulate an antitumor immune response. Recent strategy has focused on the development of combination therapy with the use of VEGF inhibitors and immune checkpoint inhibitors in the first-line setting. As more treatments are approved and the options for therapy expand further, there is a growing need for predictive biomarkers to personalize treatment choices for individual patients. Prospective clinical trials comparing the sequencing of treatments are needed to help determine the best therapeutic approach.
晚期肾细胞癌的预后历来较差,治疗选择非常有限。然而,近年来,治疗领域发生了巨大变化,为患者提供了许多新的治疗选择和改善的生存机会。新型治疗方法包括针对血管内皮生长因子 (VEGF) 途径的分子靶向药物以及免疫检查点抑制剂,它们刺激抗肿瘤免疫反应。最近的策略侧重于联合治疗,即在一线治疗中使用 VEGF 抑制剂和免疫检查点抑制剂。随着更多的治疗方法获得批准,治疗选择进一步扩大,因此需要预测性生物标志物来为个别患者的治疗选择提供个性化服务。需要进行前瞻性临床试验来比较治疗的顺序,以帮助确定最佳治疗方法。