转移性肾细胞癌免疫治疗进展后的管理。
Managing Metastatic Renal Cell Carcinoma after Progression on Immunotherapy.
机构信息
Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, 1500 East Duarte Road, Duarte, CA 91010, USA; Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubiran", Vasco de Quiroga 15 Tlalpan, Mexico City 14080, Mexico. Electronic address: https://twitter.com/ReginaBarCar.
Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, 1500 East Duarte Road, Duarte, CA 91010, USA. Electronic address: https://twitter.com/AGovindarajanMD.
出版信息
Hematol Oncol Clin North Am. 2023 Oct;37(5):965-976. doi: 10.1016/j.hoc.2023.05.005. Epub 2023 Jun 21.
Treatment of metastatic renal cell carcinoma (mRCC) after first-line immune checkpoint inhibitors (ICIs) lacks standardization, with limited evidence from small trials and retrospective data. Vascular endothelial growth factor receptor (VEGFR) inhibition through tyrosine kinase inhibitors (TKIs) is the most widely adopted second-line treatment. Encouraging results have been seen with VEGFR-TKIs in the second-line after exposure to an ICI-based combination, achieving a response rate of 30%, and 75% of patients achieving disease control. Rechallenge with ICI alone seems safe but has limited clinical benefit. Promising regimens with combination therapies and novel drugs are being evaluated in phase 3 trials.
转移性肾细胞癌（mRCC）一线免疫检查点抑制剂（ICI）治疗缺乏标准化，小型试验和回顾性数据的证据有限。通过酪氨酸激酶抑制剂（TKI）抑制血管内皮生长因子受体（VEGFR）是最广泛采用的二线治疗方法。在基于 ICI 的联合治疗后，VEGFR-TKI 在二线治疗中取得了令人鼓舞的结果，反应率为 30%，75%的患者疾病得到控制。单独重新使用 ICI 似乎是安全的，但临床获益有限。联合治疗和新型药物的有前途的方案正在 3 期临床试验中进行评估。
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