Mitsogiannis Iraklis C, Mitsogianni Maria, Papathanassiou Maria, Anagnostou Maria, Tamposis Ioannis, Mitrakas Lampros, Samara Maria, Tzortzis Vassilios, Vlachostergios Panagiotis J
Second Department of Urology, National and Kapodistrian University of Athens, Sismanoglio General Hospital, Athens, Greece.
Fourth Department of Internal Medicine, "Hygeia" Hospital, Athens, Greece.
J Kidney Cancer VHL. 2022 Sep 29;9(3):29-40. doi: 10.15586/jkcvhl.v9i3.243. eCollection 2022.
Standard systemic therapy of advanced renal cell carcinoma (RCC) involves targeting angiogenesis, mainly through tyrosine kinase inhibitors (TKI) against the vascular endothelial growth factor receptor (VEGFR) pathway and targeting the immune checkpoints, namely, programmed death-1 (PD-1) or its ligand (PD-L1), and cytotoxic T-lymphocyte-associated protein 4 (CTLA4). With current strategies of combining these two approaches in the front-line setting, less is known about optimal selection of therapy upon development of resistance in the second and later lines of treatment for progressive disease. This review discusses currently available therapeutic options in patients who have progressive RCC after prior treatment with double immune check-point inhibitors (ICIs) or ICI-TKI combinations.
晚期肾细胞癌(RCC)的标准全身治疗主要包括通过针对血管内皮生长因子受体(VEGFR)途径的酪氨酸激酶抑制剂(TKI)来靶向血管生成,以及靶向免疫检查点,即程序性死亡蛋白1(PD-1)或其配体(PD-L1),还有细胞毒性T淋巴细胞相关蛋白4(CTLA4)。对于目前在一线治疗中联合这两种方法的策略,在疾病进展的二线及后续治疗中出现耐药时,关于最佳治疗选择的了解较少。本综述讨论了在先接受双重免疫检查点抑制剂(ICI)或ICI-TKI联合治疗后出现疾病进展的RCC患者中目前可用的治疗选择。