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Allogeneic hematopoietic cell transplantation for renal cell carcinoma: ten years after.

机译:异体造血细胞移植治疗肾细胞癌:十年后。

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Introduction: The first series of patients with metastatic renal cell carcinoma (RCC) treated by non-myeloablative allogeneic hematopoietic cell transplantation (HCT) was reported in 2000 and demonstrated an allogeneic graft-versus-tumor (GVT) effect that encouraged further investigation of this approach. However, the past 10 years have also witnessed profound changes in the medical management of metastatic RCC with the introduction of targeted therapies directed against VEGF or mammalian target of rapamycin (mTOR) signaling pathways creating uncertainty about a continued role for allogeneic HCT in the treatment of RCC. Areas covered: A total of 21 published reports describing clinical outcomes for 398 patients with metastatic RCC treated by allogeneic HCT compiled herein provide a composite overview of the world wide experience for key efficacy and toxicity outcomes. Review of correlative studies that identify donor-derived T cells as mediators of RCC-specific GVT effects offers insight into both the potential as well as the technical barriers to the delivery of antigen-specific post-transplant cellular therapy or vaccination designed to augment the allogeneic GVT effect. Expert opinion: The future development of non-myeloablative allogeneic HCT for metastatic RCC will require novel treatment protocols designed to augment and sustain post-transplant GVT effects against RCC to generate renewed enthusiasm for this approach.
机译:简介:2000年报道了第一批通过非清髓性异基因造血细胞移植(HCT)治疗的转移性肾细胞癌(RCC)患者,并证明了异基因移植物抗肿瘤(GVT)的作用,这鼓励了对此的进一步研究方法。然而,在过去的十年中,随着针对VEGF或哺乳动物雷帕霉素靶标(mTOR)信号通路的靶向疗法的引入,转移性RCC的医疗管理也发生了深刻的变化,这为同种异体HCT在治疗HCC中的持续作用产生了不确定性。 RCC。涵盖的领域:共有21篇已发表的报告,描述了通过本文异基因HCT治疗的398例转移性RCC患者的临床结局,提供了有关全球主要疗效和毒性结果的综合综述。相关研究的回顾,确定了供体来源的T细胞是RCC特异性GVT效应的介体,这为了解抗原特异性移植后细胞疗法或旨在增强同种异体性疫苗接种的潜力和技术障碍提供了见解GVT效果。专家意见:用于转移性RCC的非清髓异基因HCT的未来发展将需要新颖的治疗方案,旨在增强和维持针对RCC的移植后GVT效应,以产生对该方法的新热情。

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