Kidney Cancer Working Group Report
Kidney Cancer Working Group Report
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DOI：
10.1093/jjco/hyq127
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发表时间：
2010-09-01
影响因子：
2.4
通讯作者：
Wahid, Mohamed Ibrahim Bin A.
中科院分区：
文献类型：
--
作者：
Naito, Seiji;Tomita, Yoshihiko;Wahid, Mohamed Ibrahim Bin A.
肾癌约占全球所有癌症的2%，其中肾细胞癌是最常见的形式，本报告主要关注肾细胞癌。在全球范围内，发病率和死亡率每十年增加2-3%。与西方相比，肾癌在亚洲不太常见。吸烟、肥胖、获得性囊性肾病和遗传易感性是肾癌的已知危险因素。国家综合癌症网络指南建议将手术切除作为I、II或III期肾癌患者和可切除肿瘤的IV期患者的一线治疗。免疫疗法治疗转移性肾癌已有20年的历史。高剂量白细胞介素-2（IL-2）在一些国家使用，而低剂量IL-2和干扰素-α（IFN-α）在日本很受欢迎。分子靶向药物，包括舒尼替尼，贝伐单抗和索拉非尼，正在用于以前未经治疗和难治性患者。亚洲和非亚洲人群中索拉非尼和舒尼替尼不良事件的发生率存在较大差异。共识声明：与西方国家相比，肾癌在亚洲相对罕见，但其发病率在较发达的亚洲国家正在增加。国家综合癌症网络的指南等，用于治疗转移性肾细胞癌是基于主要在西方患者中进行的III期临床试验。靶向治疗目前已成为主要推荐，但缺乏来自亚洲患者的疗效/毒性数据。一些药物对亚洲人造成不良影响，因为它们的推荐剂量对白人是最佳的，但对亚洲人来说可能太高了。进一步的研究是必要的，以制定亚洲人的最佳治疗策略。
Kidney cancer accounts for approximately 2% of all cancers worldwide, with renal cell carcinoma being the most common form and this report is focused on renal cell carcinoma. Globally, the incidence and mortality rates are increasing by 2-3% per decade. Kidney cancer is less common in Asia compared with the West. Cigarette smoking, obesity, acquired cystic kidney disease and inherited susceptibility are known risk factors for kidney cancer. The National Comprehensive Cancer Network Guidelines recommend surgical excision as first line of treatment for Stage I, II or III kidney cancer patients and Stage IV patients with resectable tumours. Immunotherapy has a 20-year history in treatment of metastatic kidney cancer. High-dose interleukin-2 (IL-2) is administered in some countries, whereas low-dose IL-2 and interferon-alpha (IFN-alpha) are popular in Japan. Molecular-targeted drugs, including sunitinib, bevacizumab and sorafenib, are being used for previously untreated and refractory patients. Asian and non-Asian populations have shown large differences in the incidences of adverse events with sorafenib and sunitinib. Consensus Statement: Kidney cancer is relatively uncommon in Asia compared with the West, but its incidence is increasing in more developed Asian nations. Guidelines from the National Comprehensive Cancer Network , etc., for treating metastatic renal cell carcinoma are based on Phase III clinical trials conducted primarily in Western patients. Targeted therapies are now becoming primary recommendations, but efficacy/toxicity data from Asian patients are lacking. Some drugs cause adverse effects in Asians because their recommended dosages are optimal for Caucasians but may be too high for Asians. Further research is necessary to develop optimal treatment strategies for Asians.