Presurgical therapy with axitinib for advanced renal cell carcinoma: a case report.
Presurgical therapy with axitinib for advanced renal cell carcinoma: a case report.
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DOI：
10.1186/1756-0500-6-484
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发表时间：
2013-11-24
影响因子：
1.8
通讯作者：
Hashimoto Y
中科院分区：
文献类型：
--
作者：
Koie T;Ohyama C;Okamoto A;Yamamoto H;Imai A;Hatakeyama S;Yoneyama T;Hashimoto Y
酪氨酸激酶抑制剂的靶向治疗已被证明可以减少肿瘤体积并延长转移性肾细胞癌患者的生存期。酪氨酸激酶抑制剂，特别是舒尼替尼，最近被用于新辅助和手术前治疗。阿西替尼是晚期或转移性肾细胞癌的二线治疗选择。在此，我们报告一位接受阿西替尼术前治疗的晚期肾细胞癌患者。一名73岁男子被救护车送往社区医院，主诉为高烧和步态障碍。计算机断层扫描显示左肾下极一高血管瘤（大小，9 × 8.5 cm）。入院时，患者一般情况较差，按照东部肿瘤合作集团绩效状态标准，评分为3分。肾肿瘤活检后，他接受5毫克阿西替尼，每天两次，持续3个月。治疗过程中未见严重不良事件发生。肿瘤直径缩小56%。行左侧根治性肾切除术，无术中及术后并发症。病理检查显示pT3aN0M0， Furman 3级，透明细胞肾细胞癌伴坏死，透明变性，含铁血黄素沉着。患者在诊断后1年无症状，无疾病。本病例研究表明，阿西替尼的术前治疗是可行的，可能对晚期肾细胞癌患者有几个潜在的优势。
Targeted therapy with tyrosine kinase inhibitors has been shown to reduce tumor volumes and prolong the survival of patients with metastatic renal cell carcinoma. Tyrosine kinase inhibitors, particularly sunitinib, have recently been used in neoadjuvant and presurgical settings. Axitinib is a promising second-line therapy option for advanced or metastatic renal cell carcinoma. Herein, we report a patient with advanced renal cell carcinoma who received presurgical treatment with axitinib. A 73-year-old man was transported by ambulance to a community hospital with chief complaints of high fever and a gait disorder. Computed tomography screening revealed a hypervascular tumor (size, 9 × 8.5 cm) in the lower pole of the left kidney. Upon admission to our hospital, his general condition was poor and his performance status was judged as 3, based on the Eastern Cooperative Oncology Group performance status criteria. After biopsy for the renal tumor, he received 5 mg of axitinib twice daily for 3 months. No serious adverse events were reported during this treatment. The tumor diameter shrank by 56%. Left radical nephrectomy was performed, and there were no intraoperative or postoperative complications. Pathological examination indicated a pT3aN0M0, Furman grade 3, clear cell renal cell carcinoma with necrosis, hyaline degeneration, and hemosiderosis. The patient was asymptomatic and disease-free at 1 year post-diagnosis. This case study demonstrate that presurgical therapy with axitinib is feasible and might have several potential advantages for patients with advanced renal cell carcinoma.