Medical treatment strategy in metastatic renal carcinoma

作者：Pouessel D; Patard J J; Culine S^*

来源：Oncologie, 2009, 11(5): 278-284.

DOI：10.1007/s10269-009-1063-z

• Renal carcinoma
• Sunitinib
• Sorafenib
• Bevacizumab
• Temsirolimus
• Everolimus

For a long time, advanced or metastatic renal carcinoma has presented a difficult therapeutic challenge in oncology practice. Only a few years ago, treatment mainly involved immunotherapy, which frequently led to stalemate. In just a few years, new therapies targeting vascular endothelial growth factors and their receptors (VEGF-R): sorafenib, sunitinib and bevacizumab, or the mammalian target of rapamycin (mTOR): temsirolimus and everolimus, have changed these patients' prognosis and also their quality of life. With these new treatments, median overall survival is more than 26 months, when it was from 10 to 12 months with immunotherapy. Published trial data mean that in 2009 we have decision-making algorithms enabling us to offer patients optimal treatment. However, patients with distinctive characteristics (cerebral metastases, papillary or chromophobe histological subtype, older patients, etc) have rarely been evaluated with respect to the effect of these molecules. A few data are reported, often concerning small samples, in retrospective or not randomised trials. For these situations, tolerance and therapeutic impact of targeted therapies will be studied in future clinical trials.

• 出版日期2009-5