Systemtherapie des metastasierten Nierenzellkarzinoms

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• 作者：L. Maute ; Prof. Dr. L. Bergmann
• 关键词：Zielgerichtete Therapien ; Tyrosinkinaseinhibitoren ; mTOR ; Inhibitoren ; Bevazizumab ; ?Immunecheckpoint-Inhibitoren ; Targeted therapy ; Tyrosinkinase inhibitors ; mTOR inhibitor ; Bevazizumab ; Immune check ; point inhibitors
• 刊名：Der Onkologe
• 出版年：2015
• 出版时间：January 2015
• 年：2015
• 卷：21
• 期：1
• 页码：35-42
• 全文大小：411 KB
• 参考文献：1. Kaatsch P, Spix C, Katalinic A et al (2013) Krebs in Deutschland 2009/2010. In Berlin: Robert Koch-Institut & Gesellschaft der epidemiologischen Krebsregister in Deutschland e.?V.
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Oncology
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1433-0415

文摘

Background Patients with metastatic renal cell carcinoma (RCC) have an unfavorable and limited prognosis. Nevertheless, the prognosis could be improved in recent years by so-called targeted therapy. Results In total seven new agents, such as tyrosine kinase inhibitors (TKI), mammalian target of rapamycin (mTOR) inhibitors and the vascular endothelial growth factor (VEGF) antibody bevacizumab have been approved for metastatic RCC and led to a prolongation of progression-free survival (PFS) and a median overall survival of 2-3 years. For first line therapy, the TKIs sunitinib and pazopanib as well as the combination of bevacizumab and interferon-alpha (IFNα) and temsirolimus for poor risk patients only are now approved. Sunitinib and pazopanib, which are restricted for use in cytokine pretreated patients, may also be administered in the second line. Axitinib compared with sorafenib improved PFS in patients pretreated with cytokines or sunitinib. Additional options in the second line or beyond are everolimus and sorafenib. Discussion The availability of new targeted agents has significantly improved the outcome and prognosis of metastatic RCC. Despite phase III trials investigating the optimal therapy sequence this has not yet been clarified due to the lack of predictive factors. Possible interesting new therapeutic options could emerge with immune check point inhibitors.