Long-term management of patients with metastatic renal cell carcinoma on targeted agents

被引:2
作者
Jonasch, Eric [1 ]
Pagliaro, Lance C. [1 ]
Tannir, Nizar M. [1 ]
机构
[1] Univ Texas MD Anderson Canc Ctr, Dept Genitourinary Med Oncol, Unit 1374, Houston, TX 77230 USA
关键词
cancer survivorship; renal cell carcinoma; targeted therapy; therapy complications; INTERFERON-ALPHA; RADICAL NEPHRECTOMY; DOUBLE-BLIND; SUNITINIB; BEVACIZUMAB; RESECTION; THERAPY; TEMSIROLIMUS; SORAFENIB; SURVIVAL;
D O I
10.1586/ERA.10.195
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Therapy for patients with metastatic renal cell carcinoma is becoming increasingly effective. Sustained partial remissions, occasional complete responses and manageable quality of life are seen in a subset of individuals. As we face the prospect of generating an increasingly large number of patients requiring long-term management, the choice and timing of systemic therapy and surgical interventions is becoming increasingly important. In this article, we review the timing and type of cytoreductive nephrectomy, what to do for patients with oligometastatic disease and how to deal with complete responders. In addition, we summarize the major side effects experienced with the commonly used molecularly targeted agents, and provide guidance on how to maximize benefit from these agents while maintaining an acceptable quality of life for patients. As treatment efficacy improves, the optimal integration of systemic therapy, surgery and toxicity management will become a critical aspect of our care for patients with metastatic renal cell carcinoma.
引用
收藏
页码:1883 / 1889
页数:7
相关论文
共 45 条
[1]   Complete remission with TKI in renal cell carcinomas: Experience in 65 patients of the French Kidney Cancer Group. [J].
Albiges, L. ;
Oudard, S. ;
Negrier, S. ;
Caty, A. ;
Gravis, G. ;
Joly, F. ;
Duclos, B. ;
Geoffrois, L. ;
Rolland, F. ;
Escudier, B. .
JOURNAL OF CLINICAL ONCOLOGY, 2010, 28 (15)
[2]   Keratoacanthomas and Squamous Cell Carcinomas in Patients Receiving Sorafenib [J].
Arnault, Jean Philippe ;
Wechsler, Janine .
JOURNAL OF CLINICAL ONCOLOGY, 2009, 27 (23) :E59-E61
[3]  
ATKINSON BJ, 2010, J CLIN ONCOL S, V28
[4]   Temsirolimus safety profile and management of toxic effects in patients with advanced renal cell carcinoma and poor prognostic features [J].
Bellmunt, J. ;
Szczylik, C. ;
Feingold, J. ;
Strahs, A. ;
Berkenblit, A. .
ANNALS OF ONCOLOGY, 2008, 19 (08) :1387-1392
[5]   Adverse effects of anticancer agents that target the VEGF pathway [J].
Chen, Helen X. ;
Cleck, Jessica N. .
NATURE REVIEWS CLINICAL ONCOLOGY, 2009, 6 (08) :465-477
[6]   Risk of Arterial Thromboembolic Events With Sunitinib and Sorafenib: A Systematic Review and Meta-Analysis of Clinical Trials [J].
Choueiri, Toni K. ;
Schutz, Fabio A. B. ;
Je, Youjin ;
Rosenberg, Jonathan E. ;
Bellmunt, Joaquim .
JOURNAL OF CLINICAL ONCOLOGY, 2010, 28 (13) :2280-2285
[7]   Cardiotoxicity associated with tyrosine kinase inhibitor sunitinib [J].
Chu, Tammy F. ;
Rupnick, Maria A. ;
Kerkela, Risto ;
Dallabrida, Susan M. ;
Zurakowski, David ;
Nguyen, Lisa ;
Woulfe, Kathleen ;
Pravda, Elke ;
Cassiola, Flavia ;
Desai, Jayesh ;
George, Suzanne ;
Morgan, Jeffrey A. ;
Harris, David M. ;
Ismail, Nesreen S. ;
Chen, Jey-Hsin ;
Schoen, Frederick J. ;
Van den Abbeele, Annick D. ;
Demetri, George D. ;
Force, Thomas ;
Chen, Ming Hui .
LANCET, 2007, 370 (9604) :2011-2019
[8]   A dipstick protein and specific gravity algorithm accurately predicts pathological proteinuria [J].
Constantiner, M ;
Sehgal, AR ;
Humbert, L ;
Constantiner, D ;
Arce, L ;
Sedor, JR ;
Schelling, JR .
AMERICAN JOURNAL OF KIDNEY DISEASES, 2005, 45 (05) :833-841
[9]   Neoadjuvant Clinical Trial With Sorafenib for Patients With Stage II or Higher Renal Cell Carcinoma [J].
Cowey, C. Lance ;
Amin, Chirag ;
Pruthi, Raj S. ;
Wallen, Eric M. ;
Nielsen, Matthew E. ;
Grigson, Gayle ;
Watkins, Cathy ;
Nance, Keith V. ;
Crane, Jeffrey ;
Jalkut, Mark ;
Moore, Dominic T. ;
Kim, William Y. ;
Godley, Paul A. ;
Whang, Young E. ;
Fielding, Julia R. ;
Rathmell, W. Kimryn .
JOURNAL OF CLINICAL ONCOLOGY, 2010, 28 (09) :1502-1507
[10]   Prospective assessment of systemic therapy followed by surgical removal of metastases in selected patients with renal cell carcinoma [J].
Daliani, Danai D. ;
Tannir, Nizar M. ;
Papandreou, Christos N. ;
Wang, Xuemei ;
Swisher, Stephen ;
Wood, Christopher G. ;
Swanson, David A. ;
Logothetis, Christopher J. ;
Jonasch, Eric .
BJU INTERNATIONAL, 2009, 104 (04) :456-460