局部细胞癌的周术系统治疗:当前的证据和未来的方向
José Pereira1, Mário Pereira-Lourenço1, Ana Maria Ferreira1
1Urology, Instituto Português de Oncologia de Coimbra, Coimbra, PRT.
Cureus
|January 15, 2026
概括
辅助 pembrolizumab 改善了高风险癌患者的生存率. 然而,针对局部细胞癌 (RCC) 的新辅助和周围手术疗法仍在研究阶段,需要更好的患者选择和试验设计.
科学领域:
- 在瘤学瘤学.
- 腎臟病學 (nephrology) 是一種醫學.
- 免疫治疗是一种免疫疗法.
- 临床试验 临床试验
背景情况:
- 在切除术后局部细胞癌 (RCC) 复发是一个重大问题,特别是具有不良的病理特征.
- 周围手术系统疗法正在探索,以消除局部RCC的微转移性疾病.
- 当前关于局部RCC新辅助剂,辅助剂和外科手术期间策略的证据需要全面审查.
研究的目的:
- 审查当前关于局部RCC的新辅助,辅助和外科手术期间系统治疗的证据.
- 概述新兴的生物见解如何为本地化RCC提供信息,可以为未来的试验设计和临床实践提供信息.
- 评估局部RCC的各种外科手术期间策略的有效性和可行性.
主要方法:
- 在2025年8月之前对II-III期研究和会议报告进行了叙述性,非系统性审查.
- 检查了报告无疾病生存率,无复发生存率,整体生存率,外科手术后可行性和转化终点的试验.
- 交叉检查数据与完整文本和会议摘要的准确性.
主要成果:
- 辅助 pembrolizumab 证明在高风险清细胞RCC中改善了无病和整体存活率,使其成为标准护理.
- 血管内皮生长因子受体 (VEGFR) 氨酸激酶抑制剂 (TKI) 和mTOR抑制剂显示出不一致的结果,缺乏明显的生存益处.
- 新辅助性免疫检查点抑制剂 (ICI),TKI和免疫瘤-氨酸激酶抑制剂 (IO-TKI) 方案是可行的和安全的,具有适度的放射性收缩,但显著的手术便利性,特别是在下静脉腔瘤血栓的情况下. 没有随机的新辅助试验改善了生存率,PROSPER RCC试验也没有改善无复发生存率.
结论:
- 辅助 pembrolizumab 是一种改变高风险清细胞RCC的治疗方法.
- 针对局部RCC的新辅助和外科治疗方法仍处于研究阶段,需要进一步研究最佳时间,持续时间和患者选择.
- 生物标志物驱动的患者选择和适应性/平台试验设计对于在RCC中推进术后免疫疗法策略至关重要.
关键词:
辅助疗法是一种辅助疗法.生物标志物 生物标志物检查点抑制剂检查点抑制剂下 vena cava 瘤 血栓 血栓 在下静脉中最少残留疾病的最小残留疾病.新辅助疗法是一种新辅助疗法.在外科手术期间进行治疗.细胞癌瘤是细胞癌.vegfr 氨酸激酶抑制剂 氨酸激酶抑制剂更多相关视频
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