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随着对肾癌发生发展过程的分子信号通路研究的不断深入,晚期肾癌的靶向治疗取得了重大进展.曾作为标准的细胞因子治疗效果不佳且有明显毒副作用,而靶向治疗已显示出在治疗晚期肾癌方面的明显优势.本文对舒尼替尼、索拉非尼、贝伐单抗、帕唑帕尼、Temsirolimus、依维莫司六种靶向药物的临床疗效,毒副作用以及对策,在贯序治疗、联合治疗和新辅助治疗方面的进展作一综述. 相似文献
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肿瘤分子靶向治疗是在肿瘤分子生物学的基础上,以肿瘤相关的分子作为靶点,利用靶分子特异制剂或药物进行治疗。从2006年9月索拉非尼在中国上市,晚期肾癌的治疗进入靶向治疗时代已经走过了11年的历程。本综述主要通过回顾肿瘤分子靶向治疗的发展历程,探讨VEGF抑制剂治疗晚期肾癌的疗效,思考临床中遇到的问题,提出晚期肾癌靶向治疗的建议。 相似文献
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原发于肾脏的恶性肿瘤中约90%为肾细胞癌(Renal Cell Carcinoma,RCC),RCC是泌尿系中发病率仅次于膀胱癌的恶性肿瘤,包括透明细胞癌(占70%-80%),乳头状细胞癌(占10%~15%),嫌色细胞癌(约占5%),集合管癌和髓质癌(约占1%)等病理类型。肉瘤样改变可出现于以上各种病理类型(最新的分类未将其作为一个单独的病理类型),其出现往往预示着预后不良。 相似文献
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转移性肾癌的靶向治疗 总被引:1,自引:0,他引:1
转移性肾癌是一种对于传统化、放疗较不敏感的不可治愈性疾病。虽然免疫治疗对部分患者具一定疗效,但疗效通常并不持久,且治疗可能导致严重的毒副作用。随着近年来对肾癌生物学及分子发病机制的加深理解,针对使用多种靶向治疗药物治疗肾癌的研究取得了可喜的成果。无论针对初治或以往治疗失败的患者,靶向治疗均显示出高于传统治疗的优越性。此外,治疗的耐受性非常良好,并不影响患者的生存质量。本综述将依据最新的临床证据,着重围绕目前主要的治疗进展加以分别阐述,同时简单概括相关的治疗靶点信息,力求使读者在基础和临床两方面对转移性肾癌的靶向治疗获得较为深刻的认识。 相似文献
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肾细胞癌(RCC)是一种起源于肾小管上皮细胞的恶性肿瘤,是我国泌尿系统肿瘤中发病率仅次于膀胱癌的常见的恶性肿瘤之一,其发生比例约占所有肾脏肿瘤的85%。虽然手术可治愈大部分早期患者,但约25%的局部进展及20%~30%的局限 相似文献
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肾细胞癌靶向治疗研究现状 总被引:1,自引:1,他引:0
肾细胞癌被认为是最难治的恶性肿瘤之一。由于对肾细胞癌分子发病机制研究的进一步深入,在晚期肾细胞的治疗中出现了一系列成功范例。在过去20年,非特异性免疫治疗被认为是晚期肾细胞癌治疗标准。近年,随着分子靶向药物的研发和临床使用,肿瘤的分子靶向治疗已成为肿瘤治疗的研究热点,同时由于对肾细胞癌进一步了解,肾细胞癌的治疗已开始转向抗-血管内皮生长因子及其相关通路研究,大量的临床研究试验,证明了分子靶向治疗在晚期肾细胞癌的疗效,其中Sorafenib(索拉非尼)和Sunitinib(舒尼替尼)分别于2005年和2006年经美国FDA批准用于晚期肾细胞癌。本文将围绕VEGF在肾细胞癌的重要性和Bevacizumab(贝伐单抗)、Sunitinib和So-rafenib治疗晚期肾细胞癌研究进展等问题进行简要阐述。 相似文献
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肾细胞癌(RCC )是难治的恶性肿瘤之一,对放化疗不敏感,免疫治疗方式有效率一直徘徊于10% ~15% 。随着对肿瘤分子机制的深入以及多种分子靶向药物的深入研究,靶向治疗取得了重大进展。肾癌的发病机制与VHL 、Ras、PTEN等抑癌基因的突变有关,可诱导其下游的蛋白激酶受体表达异常。而蛋白激酶抑制剂可以通过干扰细胞内信号传导通路及改变肿瘤细胞微环境而影响肿瘤细胞的存活和增殖,是当前研发最集中的靶向治疗药物之一。近年来,多项靶向药物临床试验的可喜结果为转移性肾细胞癌(mRCC)治疗带来了新希望。本文就2009年NCCN 肿瘤治疗指南中介绍的舒尼替尼、索拉非尼、Temsirolimus、贝伐单抗等四种药物在肾细胞癌靶向治疗方面的临床研究最新进展展开综述。 相似文献
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目的 探讨索拉非尼对治疗晚期肾癌的临床治疗效果与安全性.方法 选取56例晚期肾癌患者作为研究对象,使用索拉非尼作为其一线单独用药,口服索拉非尼400mg,2次/d,观察患者的治疗效果以及不良反应.结果 完全缓解0例、部分缓解9例、42例患者病情稳定、5例患者疾病进展,客观反应率为16.1 (9/56),疾病控制率达到91.1% (51/56).结论 索拉非尼对处于晚期肾癌患者有良好的治疗效果,不良反应深度较轻,具有良好的安全性和耐受性. 相似文献
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Outcomes for patients with advanced renal cell carcinoma (RCC) have improved significantly in recent years with the development of novel noncytotoxic systemic therapies. The multitargeted kinase inhibitors sunitinib and sorafenib have been approved for the treatment of advanced RCC, and bevacizumab, a monoclonal anti–vascular endothelial growth factor antibody, has shown significant clinical activity, both as a single agent and in combination with interferon‐α. The mammalian target of rapamycin inhibitors temsirolimus and everolimus have led to longer overall survival times in poor‐risk patients in the first‐line setting and longer progression‐free survival times in kinase inhibitor refractory patients in the second‐line setting, respectively. Despite these advances, almost all patients develop resistance to treatment and cure is rarely seen. There is therefore a need to overcome resistance, induce longer lasting remissions, and improve survival. A potential approach to this is to combine active agents, and the clinical data for combination therapy with novel targeted agents in advanced RCC are reviewed here. 相似文献
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进展期肾癌预后较差,近年来免疫治疗和靶向治疗发展较快,新药Sorafenib、Sunitinib、Temsirolimas、Bevacizumab等的应用,取得一定疗效。该文对进展期肾癌的治疗现状及进展作一综述。 相似文献
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肾细胞癌是泌尿系统肿瘤中常见的恶性肿瘤,发病率约5~10/10万。转移性肾细胞癌在以细胞因子为基础的治疗失败后,尚无明确的二线治疗措施。随着对乏氧诱导因子(hypoxia-inducible factor,HIF)相关蛋白的研究,转移性肾细胞癌分子靶向治疗研究成为热点。本文综述较有前景的靶向药物,包括Bevacizumab(贝伐单抗)、Sorafenib(索拉非尼)、Sunitinib(舒尼替尼)、AG-013736、Vatalanib(PTK787)、Thalidomide(沙利度胺)及Temsirolimus(CCI-779)。 相似文献
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We present a case of renal cell carcinoma with metastasis to the ipsilateral spermatic cord. We report the clinical presentation and management of this case and review the scientific literature of this unusual case presentation. 相似文献
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《Clinical genitourinary cancer》2014,12(5):354-358
Introduction/BackgroundTargeted therapy has become the mainstay of treatment for mRCC. The efficacy of this therapy in the older population is poorly understood.Patients and MethodsData from patients with mRCC treated with first-line anti-VEGF therapy were collected through the International mRCC Database Consortium from 12 centers. Patient characteristics, data on second-line therapy, and outcomes including treatment duration and overall survival, were evaluated using summary statistics and multivariate analysis.ResultsAll patients (n = 1381) were treated with front-line targeted therapy; 144 (10%) were 75 years old or older. Six patients (4%) were favorable risk, 99 patients (69%) intermediate risk, and 39 patients (27%) poor risk according to Heng Journal of Clinical Oncology 2009 prognostic factors. The initial treatment for those ≥ 75 years of age was sunitinib (n = 98), sorafenib (n = 35), bevacizumab (n = 7), and AZD217 (n = 4). Twenty-three percent of older patients and 39% of the younger patients went on to receive second-line therapy (P < .0001). The overall response rate, median treatment duration, and overall survival for the older versus younger group were 18% versus 25% (P = .0975), 5.5 months versus 7.5 months (P = .1388), and 16.8 months versus 19.7 months (P = .3321), respectively. When adjusted for poor prognostic factors, age 75 years and older was not found to be associated with poorer overall survival (hazard ratio [HR], 1.002; 95% confidence interval [CI], 0.781-1.285) or shorter treatment duration (HR, 1.018; 95% CI, 0.827-1.252). The retrospective study design was the primary limitation.ConclusionThe use of advanced age as a selection criterion for targeted therapy requires further study, with data suggesting no clinically meaningful differences in overall response rate, treatment duration, and overall survival between older and younger age groups. 相似文献