Molecular Biomarkers in Advanced Renal Cell Carcinoma
Molecular Biomarkers in Advanced Renal Cell Carcinoma
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DOI：
10.1158/1078-0432.ccr-13-1351
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发表时间：
2014-04-15
影响因子：
11.5
通讯作者：
Rini, Brian
中科院分区：
文献类型：
--
作者：
Maroto, Pablo;Rini, Brian
近年来，直接针对致瘤和血管生成途径的药物的出现显着改善了晚期肾细胞癌（RCC）患者的预后。然而，所有患者最终都会产生耐药性，并且相当大比例的患者在一线靶向治疗后会立即出现疾病进展。此外，患者对不同药物（包括同一类别的药物）具有不同的临床益处和/或耐受性。因此，目前针对个体患者的治疗选择仍然是经验性的。在这种情况下，为了指导治疗，人们对几种分子生物标志物进行了研究。本综述讨论了与独立于治疗的患者结局相关的预后生物标志物，以及治疗反应的预测生物标志物，包括循环生物标志物（例如 VEGF 和 VEGF 相关蛋白、细胞因子和血管生成因子以及乳酸脱氢酶）和基于组织的生物标志物（例如单核苷酸多态性）。目前，许多潜在的预后和预测性分子生物标志物已在肾细胞癌中被发现，但尚未进入临床实践，并且所有标志物都需要在适当设计的随机研究中进行前瞻性验证。然而，在不久的将来，经过验证的生物标志物可能会成为肾细胞癌管理策略的组成部分，从而为个体患者提供量身定制的治疗，以改善临床结果。 (C) 2014 年 AACR。
The availability of agents directly targeting tumorigenic and angiogenic pathways has significantly improved the outcomes of patients with advanced renal cell carcinoma (RCC) in recent years. However, all patients eventually become resistant and a substantial percentage experience immediate disease progression with first-line targeted therapy. In addition, patients have variable clinical benefit and/or tolerance to different agents, including drugs within the same class. Thus, the choice of therapy for an individual patient remains empiric at present. Upon this landscape, several molecular biomarkers have been investigated with the purpose of guiding therapy. This review discusses prognostic biomarkers correlating with the outcome of patients independent of therapy, and predictive biomarkers of treatment response, including circulating biomarkers (such as VEGF and VEGF-related proteins, cytokine and angiogenic factors, and lactate dehydrogenase), and tissue-based biomarkers (such as single-nucleotide polymorphisms). Many potential prognostic and predictive molecular biomarkers have now been identified in RCC, although none has yet entered into clinical practice, and all require prospective validation in appropriately designed randomized studies. In the near future, however, validated biomarkers may become integral to management strategies in RCC, enabling tailored treatment for individual patients to improve clinical outcomes. (C) 2014 AACR.