Primary and acquired resistance to first-line therapy for clear cell renal cell carcinoma  

作　　者：Serena Astore Giulia Baciarello Linda Cerbone Fabio Calabrò 

机构地区：[1]Medical Oncology,San Camillo Forlanini Hospital,Rome 00152,Italy [2]Medical Oncology,IRCSS,National Cancer Institute Regina Elena,Rome 00128,Italy

出　　处：《Cancer Drug Resistance》2023年第3期517-546,共30页癌症耐药（英文）

摘　　要：The introduction of first-line combinations had improved the outcomes for metastatic renal cell carcinoma (mRCC) compared to sunitinib. However, some patients either have inherent resistance or develop resistance as a result of the treatment. Depending on the kind of therapy employed, many factors underlie resistance to systemic therapy. Angiogenesis and the tumor immune microenvironment (TIME), nevertheless, are inextricably linked. Although angiogenesis and the manipulation of the tumor microenvironment are linked to hypoxia, which emerges as a hallmark of renal cell carcinoma (RCC) pathogenesis, it is only one of the potential elements involved in the distinctive intra- and inter-tumor heterogeneity of RCC that is still dynamic. We may be able to more correctly predict therapy response and comprehend the mechanisms underlying primary or acquired resistance by integrating tumor genetic and immunological markers. In order to provide tools for patient selection and to generate hypotheses for the development of new strategies to overcome resistance, we reviewed the most recent research on the mechanisms of primary and acquired resistance to immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs) that target the vascular endothelial growth factor receptor (VEGFR).We can choose patients’ treatments and cancer preventive strategies using an evolutionary approach thanks to the few evolutionary trajectories that characterize ccRCC.

关 键 词：Renal cell carcinoma RESISTANCE tumor microenvironment checkpoint inhibitors target therapy 

分 类 号：R737.11[医药卫生—肿瘤]