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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。
Renal cell carcinoma (RCC) is one of refractory malignant tumors, which is not sensitive to radiotherapy and chemotherapy. The efficiency of immunotherapy has been hovering at 10% -15%. With the deepening of molecular mechanisms of the tumor and further research on various molecularly targeted drugs, significant progress has been made in targeted therapy. The pathogenesis of renal cell carcinoma is related to the mutation of tumor suppressor genes such as VHL, Ras and PTEN, which can induce the abnormal expression of protein kinase receptor in its downstream. Protein kinase inhibitors can affect the survival and proliferation of tumor cells by interfering with intracellular signal transduction pathways and changing the microenvironment of tumor cells, which is one of the most concentrated targeted therapeutics currently under development. In recent years, many promising results of targeted drug clinical trials have brought new hope for the treatment of metastatic renal cell carcinoma (mRCC). This review summarizes the recent advances in the clinical research of targeted therapy of renal cell carcinoma with sunitinib, sorafenib, temsirolimus and bevacizumab introduced in the 2009 NCCN Guidelines for Cancer Therapy.