Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluative Sciences, University of Toronto, Toronto, Ontario, Canada.
Institute of Health Policy, Management and Evaluative Sciences, University of Toronto, Toronto, Ontario, Canada; Toronto Health Economic and Technology Assessment Collaboration, University Health Network, Toronto, Ontario, Canada; Public Health Ontario, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Crit Rev Oncol Hematol. 2020 Aug;152:102971. doi: 10.1016/j.critrevonc.2020.102971. Epub 2020 Jun 1.
The treatment landscape for metastatic renal cell carcinoma (mRCC) has undergone a substantial evolution in the past decade, with a dramatic increase in the number of available systemic therapies. Although this offers promise for improved patient outcomes, this rapid pace in development has led to new challenges in therapeutic choice. For instance, the absence of direct comparative evidence across all therapeutic options has led to a critical gap in evidence to clearly define preferred systemic therapy choice. Additionally, the rising cost of systemic therapies being evaluated for mRCC necessitates demonstration of cost-effectiveness prior to widespread adoption. This review provides an overview of the current treatment landscape in mRCC to highlight the emerging challenges faced by clinicians and health policy-makers. In addition, this review summarizes the currently available evidence that aims to address the above challenges.
过去十年中，转移性肾细胞癌（mRCC）的治疗格局发生了重大变化，可用于治疗的系统疗法数量显著增加。尽管这为改善患者预后带来了希望，但这种快速的发展步伐也带来了治疗选择方面的新挑战。例如，由于缺乏所有治疗选择的直接比较证据，因此在明确定义首选系统治疗选择方面存在明显的证据空白。此外，正在评估的用于 mRCC 的系统疗法的成本不断上升，这就需要在广泛采用之前证明其具有成本效益。本文综述了 mRCC 的当前治疗格局，以强调临床医生和卫生政策制定者所面临的新挑战。此外，本文还总结了目前旨在解决上述挑战的可用证据。
