肾细胞癌的新治疗方法.pptVIP

Gaetano Facchini, Francesco Perri, Michele Caragliae, et al. Anti-Cancer Drugs 2009, 20:893–900 New treatment approaches in renal cell carcinoma * Renal cell carcinoma (RCC) is a fairly common tumor, accounting for 3% of all human cancers Up until recently, immunotherapy has represented the treatment of choice Introduction(1) * In particular, interferon-a (IFN-a) has been shown to produce objective responses in 10–15% of patients with a median survival of approximately 12 months High-dose interleukin-2 was approved by the US Food and Drug Administration because of a small percentage of durable complete responses (4%) However, this treatment was associated with severe toxicity and clinical benefit was observed only in a few good prognosis patients Introduction(2) * The therapeutic armamentarium against RCC has been greatly enriched over the last few years because of progress in the understanding of the biology of RCC, which has paved the way to clinical trials with targeted therapies Introduction(3) * Most of what we know about the genetic basis of RCC has been learnt from studies of the inherited forms; in fact, the genes linked to hereditary cancers often play important roles in their nonhereditary counterparts ? There are four well-defined hereditary types of RCC: von Hippel–Lindau, (VHL), hereditary papillary renal carcinoma, Birt–Hogg–Dube ` (BHD), and hereditary leiomyomatosis RCC (HLRCC) Understanding RCC biology: the way to move to targeted therapie(1) * VHL mutations are very common (75%) in patients with sporadic clear-cell RCC,suggesting that it may be a very early step in renal carcinogenesis The VHL gene has the characteristics of a tumor suppressor gene and encodes for a protein called pVHL, which is able to downregulate several intracellular proteins such as hypoxia inducible factor (HIF), 1a and 2a Understanding RCC biology: the way to move to targeted therapie(2) * Understanding RCC biology: the way to move to targeted therapie(