肾细胞癌靶向治疗的临床研究进展

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。

Clinical Progress in the Targeted Therapy for Renal Cell Carcinoma

Renal cell carcinoma(RCC)is currently one of treatment-resistant malignancies and is not sensitive to conventional radiotherapy or chemotherapy.The effective rate of high dose of recombinant human interleukin-2(IL-2)and recombinant human interferon-α(IFN-α)was only 10%-15%.Advances in the understanding of cancer at molecular level have led to more progress in the development of anti-cancer agents.Recently,mutation of Von Hippel-Lindau(VHL),Ras,PTEN genes have been observed in RCC and the mutation can result in different expression levels of RTK.Among the newly invented medications for targeted cancer therapy,protein kinase inhibitors target intracellular molecules crucial in sighaling pathways of cancer cell survival and proliferation.Compared with conventional chemotherapy and immune therapy,targeted therapy is effective,with fewer adverse effects.According to 2009 NCCN Clinical Practice Guidelines in oncology,this article reviewed the clinical application of sunitinib,sorafenib,temsirolimus,and bevacizumab in the targeted therapy for renal cell carcinoma.