Jiang Aimin, Li Jinxin, He Ziwei, Liu Ying, Qiao Kun, Fang Yu, Qu Le, Luo Peng, Lin Anqi, Wang Linhui
Department of Urology Changhai Hospital Naval Medical University Shanghai China.
Department of Urology Jinling Hospital Affiliated Hospital of Medical School Nanjing University Nanjing China.
MedComm (2020). 2024 Aug 1;5(8):e676. doi: 10.1002/mco2.676. eCollection 2024 Aug.
Renal cancer is a highlyheterogeneous malignancy characterized by rising global incidence and mortalityrates. The complex interplay and dysregulation of multiple signaling pathways,including von Hippel-Lindau ()/hypoxia-inducible factor (), phosphoinositide 3-kinase ()/protein kinase B ()/mammalian target of rapamycin (), Hippo-yes-associated protein (), Wnt/ß-catenin, cyclic adenosine monophosphate (), and hepatocyte growth factor ()/, contribute to theinitiation and progression of renal cancer. Although surgical resection is thestandard treatment for localized renal cancer, recurrence and metastasiscontinue to pose significant challenges. Advanced renal cancer is associatedwith a poor prognosis, and current therapies, such as targeted agents andimmunotherapies, have limitations. This review presents a comprehensiveoverview of the molecular mechanisms underlying aberrant signaling pathways inrenal cancer, emphasizing their intricate crosstalk and synergisticinteractions. We discuss recent advancements in targeted therapies, includingtyrosine kinase inhibitors, and immunotherapies, such as checkpoint inhibitors.Moreover, we underscore the importance of multiomics approaches and networkanalysis in elucidating the complex regulatory networks governing renal cancerpathogenesis. By integrating cutting-edge research and clinical insights, this review contributesto the development of innovative diagnostic and therapeutic strategies, whichhave the potential to improve risk stratification, precision medicine, andultimately, patient outcomes in renal cancer.
肾癌是一种高度异质性的恶性肿瘤,其全球发病率和死亡率呈上升趋势。多种信号通路之间复杂的相互作用和失调,包括冯·希佩尔-林道(VHL)/缺氧诱导因子(HIF)、磷酸肌醇3激酶(PI3K)/蛋白激酶B(AKT)/雷帕霉素哺乳动物靶蛋白(mTOR)、Hippo-Yes相关蛋白(YAP)、Wnt/β-连环蛋白、环磷酸腺苷(cAMP)和肝细胞生长因子(HGF)/c-Met,都促成了肾癌的发生和发展。尽管手术切除是局限性肾癌的标准治疗方法,但复发和转移仍然是重大挑战。晚期肾癌预后较差,目前的治疗方法,如靶向药物和免疫疗法,都存在局限性。本综述全面概述了肾癌中异常信号通路的分子机制,强调了它们复杂的相互作用和协同作用。我们讨论了靶向治疗的最新进展,包括酪氨酸激酶抑制剂,以及免疫疗法,如检查点抑制剂。此外,我们强调了多组学方法和网络分析在阐明控制肾癌发病机制的复杂调控网络中的重要性。通过整合前沿研究和临床见解,本综述有助于开发创新的诊断和治疗策略,这些策略有可能改善肾癌的风险分层、精准医学,并最终改善患者预后。