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Strategies to over come therapeutic resistance in renal cell carcinoma

机译:肾细胞癌的治疗抗性抗策略

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摘要

Background:Renal cell cancer (RCC) is a prevalent and lethal disease. At time of diagnosis, most patients present with localized disease. For these patients, the standard of care includes nephrectomy with close monitoring thereafter. While many patients will be cured, 5-year recurrence rates range from 30% to 60%. Furthermore, nearly one-third of patients present with metastatic disease at time of diagnosis. Metastatic disease is rarely curable and typically lethal. Cytotoxic chemotherapy and radiation alone are incapable of controlling the disease. Extensive effort was expended in the development of cytokine therapies but response rates remain low. Newer agents targeting angiogenesis and mTOR signaling emerged in the 2000s and revolutionized patient care. While these agents improve progression free survival, the development of resistance is nearly universal. A new era of immunotherapy is now emerging, led by the checkpoint inhibitors. However, therapeutic resistance remains a complex issue that is likely to persist.
机译:背景:肾细胞癌(RCC)是一种普遍性和致命的疾病。在诊断时,大多数患者存在局部疾病。对于这些患者,护理标准包括随后接近监测的肾切除术。虽然许多患者将被治愈,但5年的复发率范围为30%至60%。此外,在诊断时,近三分之一的患者患有转移性疾病。转移性疾病很少可固化,通常是致命的。单独的细胞毒性化学疗法和辐射不能控制这种疾病。广泛的努力消耗了细胞因子疗法的发展,但反应率保持低位。在2000年代出现靶向血管生成和MTOR信号的较新剂量,并彻底改变了患者护理。虽然这些药剂改善了进展的自由生存期,但抗性的发展几乎是普遍的。目前,通过检查点抑制剂引发了一种新的免疫疗法时代。然而,治疗抵抗仍然是一个可能持续存在的复杂问题。

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