Оптимизация последовательной таргетной терапии

Почечно-клеточный рак (ПКР) занимает одно из ведущих мест по заболеваемости в мире среди злокачественных новообразований мочеполовой системы, около 25–30 % первичных больных выявляют на стадии метастатического почечно-клеточного рака (мПКР). С 2005 г. по настоящее время для лечения мПКР зарегистрировали и одобрили к применению 10 таргетных и иммуноонкологических препаратов. Быстрый рост терапевтических возможностей лечения мПКР создал проблему выбора для практикующих онкологов и урологов и необходимость понимания принципов оптимизации последовательной таргетной терапии для достижения максимальной эффективности каждой линии лечения. В статье обсуждаются вопросы правильного выбора препаратов 1-й линии таргетной терапии, оптимального дозирования сунитиниба и акситиниба, альтернативных и альтернирующих режимов применения сунитиниба, а также влияние объективного ответа и артериальной гипертензии, развившейся при таргетной терапии, на эффективность лечения.

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