Update on the treatment of metastatic renal cell carcinoma  

作　　者：Rafael Antonio Medina Lopez Ines Rivero Belenchon Javier Mazuecos-Quiros Carmen Belen Congregado-Ruiz Felipe Counago 

机构地区：[1]Department of Urology and Nephrology,Virgen del Rocio University Hospital,Biomedical Institute of Seville/CSIC/University of Seville,Sevilla 41013,Spain [2]Department of Urology and Nephrology,Virgen del Rocio University Hospital,Seville 41005,Spain [3]Radiation Oncology,Hospital Universitario Quironsalud,Hospital La Luz,Universidad Europea de Madrid,Madrid 28223,Spain

出　　处：《World Journal of Clinical Oncology》2022年第1期1-8,共8页世界临床肿瘤学杂志（英文版）

摘　　要：Metastatic renal cell cancer(mRCC)management has undergone a paradigm shift in recent decades.The first revolution came with the emergence of vascular endothelial growth factor inhibitors;there was a second wave with the unprecedented success of checkpoint inhibitors,and then the latest approach,which is becoming the new care standard in mRCC,of combining these two strategies in different ways.Updated results of Checkmate-214 after 42 mo of follow-up were consistent with previously published results showing the superiority of nivolumab/ipilimumab over sunitinib in progression free survival(PFS),overall survival(OS),and objective response rate(ORR)in intermediate and high-risk patients.However,several studies presented at the American Society of Clinical Oncology 2020 suggested that the best place,and so far,the only one for nivolumab/ipilimumab is the frontline setting.The update on Keynote-426 after 23 mo of follow-up showed no superiority of pembrolizumab/axitinib over sunitinib in favorable-risk mRCC,suggesting that it should no longer be the first line of choice in low-risk patients.Finally,the phase III Checkmate 9ER trial results revealed the superiority of nivolumab/cabozantinib vs sunitinib in PFS,OS,and ORR,providing a new first-line option among all International Metastatic RCC Database Consortium risk patients.Some phase II clinical trials also presented this year showed promising results with new combination therapies such as nivolumab/sitravatinib,cabozantinib/atezolizumab,and lenvatinib/pembrolizumab,providing promising grounds upon which to start phase III studies.In addition,other works are using novel therapeutic agents with different mechanisms of action,including telaglenastat(a glutaminase inhibitor),entinostat[an inhibitor of histone deacetylases(HDACs)],and olaparib and talazoparib,poly(ADP-ribose)polymerase inhibitors widely used in other tumors.However,some questions regarding mRCC management still need to be addressed,such as head-to-head comparisons between the current options,treatment

关 键 词：Metastatic renal cell carcinoma Systemic treatment Immune checkpoint inhibitors ANTIANGIOGENIC UPDATE Biomarkers 

分 类 号：R73[医药卫生—肿瘤]