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Progress Toward Precision Medicine in Frontline Treatment of Metastatic Renal Cell Carcinoma
JAMA Oncology ( IF 28.4 ) Pub Date : 2020-01-01 , DOI: 10.1001/jamaoncol.2019.4716
Nirmish Singla 1, 2
Affiliation  

As molecular understanding of cancer biology evolves, precision medicine will play a growing role in guiding therapy. This is certainly evident in the case of metastatic renal cell carcinoma (mRCC), which is inherently a heterogeneous tumor type on both clinical and molecular levels. The treatment approach for mRCC has evolved considerably over the past couple of decades, since the original cytokine era of interleukin-2 and interferon-α. The targeted therapy era for mRCC, which dominated throughout most of the 2000s, was the first foray into precision medicine.1 It capitalized on pathways implicated in tumorigenesis and disease progression. Among the therapeutic classes introduced, angiogenic inhibitors emerged as the most promising agents and defined the new standard of care for treating mRCC. The efficacy of these agents highlights the unique biology underlying clear-cell renal cell carcinoma (ccRCC), the most common histologic subtype, in which von Hippel–Lindau gene (VHL) inactivation induces angiogenesis via the accumulation of hypoxia-inducible factors. Although encouraging, several patients with ccRCC have remained resistant to these therapies,2 requiring novel approaches to treatment.



中文翻译:

转移性肾细胞癌一线治疗的精准医学进展

随着对癌症生物学的分子理解的发展,精准医学将在指导治疗方面发挥越来越大的作用。这在转移性肾细胞癌 (mRCC) 的情况下当然很明显,它在临床和分子水平上本质上是一种异质性肿瘤类型。自白细胞介素 2 和干扰素 α 的原始细胞因子时代以来,mRCC 的治疗方法在过去几十年中发生了很大变化。mRCC 的靶向治疗时代在 2000 年代的大部分时间里占主导地位,是第一次涉足精准医学。1它利用了与肿瘤发生和疾病进展有关的途径。在引入的治疗类别中,血管生成抑制剂成为最有前途的药物,并定义了治疗 mRCC 的新护理标准。这些药物的功效突出了透明细胞肾细胞癌 (ccRCC) 的独特生物学特性,ccRCC 是最常见的组织学亚型,其中 von Hippel-Lindau 基因 ( VHL ) 失活通过缺氧诱导因子的积累诱导血管生成。尽管令人鼓舞,但一些 ccRCC 患者仍然对这些疗法产生抗药性,2需要新的治疗方法。

更新日期:2020-01-09
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