Recent progress in the management of advanced renal cell carcinoma
Recent progress in the management of advanced renal cell carcinoma
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DOI：
10.3322/canjclin.57.2.112
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发表时间：
2007-03-01
影响因子：
254.7
通讯作者：
Rini, Brian I.
中科院分区：
文献类型：
--
作者：
Garcia, Jorge A.;Rini, Brian I.
对肾细胞癌（RCC）分子生物学的更好理解导致了转移性疾病患者治疗的巨大范式转变。历史上，使用细胞因子的非特异性免疫方法被采用，但最近这已经过渡到针对血管内皮生长因子（VEGF）和相关途径的分子靶向方法。几种抗VEGF药物，包括配体结合剂如贝伐单抗和VEGF和相关受体的小分子抑制剂如舒尼替尼和索拉非尼，已在转移性RCC患者中显示出临床活性。抑制替代靶点如雷帕霉素的哺乳动物靶点（mTOR）的其他药剂也已显示出活性。这一代新的分子靶向疗法继续显示出巨大的前景。本文旨在总结转移性肾细胞癌的治疗现状，并探讨其未来的发展方向。
A better understanding of the molecular biology of renal cell carcinoma (RCC) has led to a dramatic paradigm shift in the treatment of patients with metastatic disease. Historically, a nonspecific immune approach using cytokines was employed, but recently this has transitioned to a molecularly-targeted approach against vascular endothelial growth factor (VEGF) and related pathways. Several anti-VEGF agents, including ligand-binding agents such as bevacizumab and the small molecule inhibitors of VEGF and related receptors such as sunitinib and sorafenib, have demonstrated clinical activity in patients with metastatic RCC. Other agents that inhibit alternative targets such as the mammalian target of rapamycin (mTOR) have also demonstrated activity. This generation of novel molecular targeted therapies continues to show great promise. The purpose of this review is to summarize the current management and to discuss potential future directions in the management of metastatic RCC.