Baston Catalin, Parosanu Andreea Ioana, Stanciu Ioana-Miruna, Nitipir Cornelia
Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 8 Sanitary Heroes Boulevard, 050474 Bucharest, Romania.
Department of Urology, Fundeni Clinical Institute, 022328 Bucharest, Romania.
Biomedicines. 2024 May 16;12(5):1111. doi: 10.3390/biomedicines12051111.
The management of renal cell carcinoma (RCC) has been revolutionized over the past two decades with several practice-changing treatments. Treatment for RCC often requires a multimodal approach: Local treatment, such as surgery or ablation, is typically recommended for patients with localized tumors, while stage IV cancers often require both local and systemic therapy. The treatment of advanced RCC heavily relies on immunotherapy and targeted therapy, which are highly contingent upon histological subtypes. Despite years of research on biomarkers for RCC, the standard of care is to choose systemic therapy based on the risk profile according to the International Metastatic RCC Database Consortium and Memorial Sloan Kettering Cancer Centre models. However, many questions still need to be answered. Should we consider metastatic sites when deciding on treatment options for metastatic RCC? How do we choose between dual immunotherapy and combinations of immunotherapy and tyrosine kinase inhibitors? This review article aims to answer these unresolved questions surrounding the concept of personalized medicine.
在过去二十年中，肾细胞癌（RCC）的治疗因多种改变治疗方式的疗法而发生了变革。RCC的治疗通常需要多模式方法：对于局限性肿瘤患者，通常推荐采用局部治疗，如手术或消融，而IV期癌症通常需要局部和全身治疗。晚期RCC的治疗严重依赖免疫疗法和靶向疗法，这高度取决于组织学亚型。尽管对RCC的生物标志物进行了多年研究，但护理标准是根据国际转移性RCC数据库联盟和纪念斯隆凯特琳癌症中心模型，根据风险概况选择全身治疗。然而，许多问题仍有待解答。在决定转移性RCC的治疗方案时，我们是否应该考虑转移部位？我们如何在双重免疫疗法以及免疫疗法与酪氨酸激酶抑制剂的联合疗法之间做出选择？这篇综述文章旨在回答围绕个性化医疗概念的这些未解决问题。
