Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press11510.17650/1726-9776-2013-9-3-37-42DIAGNOSIS AND TREATMENT OF URINARY SYSTEM TUMORS. RENAL CANCERДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ МОЧЕПОЛОВОЙ СИСТЕМЫ. Рак почкиIMMUNOTHERAPY FOR METASTATIC KIDNEY CANCER: ITS ROLE AT THE PRESENT STAGE AND PROSPECTS FOR CLINICAL APPLICATIONИММУНОТЕРАПИЯ ПРИ МЕТАСТАТИЧЕСКОМ РАКЕ ПОЧКИ: ЕЕ РОЛЬ НА СОВРЕМЕННОМ ЭТАПЕ И ПЕРСПЕКТИВЫ КЛИНИЧЕСКОГО ИСПОЛЬЗОВАНИЯNosovD. A.НосовД. А.
Russian Federation
nosov@mail.ruVoroshilovaE. A.ВорошиловаЕ. А.
Russian Federation
nosov@mail.ruSayapinaM. S.СаяпинаМ. С.
Russian Federation
nosov@mail.ruN.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, MoscowФГБУ «РОНЦ им. Н.Н. Блохина» РАМН, Москва300920139337422707201427072014https://oncourology.abvpress.ru/oncur/article/view/115

With the clinical introduction of targeted drugs, the results of therapy in patients with metastatic renal-cell carcinoma (mRCC) of all prognostic groups as witnessed by the data of randomized trials. Nevertheless, there is a group of favorable prognosis patients (MSKCC) that may use first-line immunotherapy equally with a targeted approach without apparently affecting overall survival. As a rule, these are the patients who have no symptoms of the disease with the primary tumor being removed and the disease is being minimally disseminated. At the same time, how long very rare (1 %) complete remissions achieved by targeted drugs last, whether they can transformed into complete recovery, and how this may be observed in 3–4 % of cases when immune therapeutic options are used in favorable prognosis patients remain to be investigated. Due to the fact that nonspecific therapy involving cytokines fails to overcome fully the phenomenon of immunological tumor tolerance and has limited antitumor activity, the clinical trials are actively studying the efficiency of more specific immunotherapeutic approaches, such as anti-CTLA-4, anti-PD1 monoclonal antibodies, as well as different vaccination types.

Thus, there is an opportunity to make the immunotherapeutic approach molecular targeted and to integrate it into a drug treatment algorithm for patients with mRCC. Accordingly, the priority for additional clinical trials is to identify predictive markers of response (or resistance) to immunotherapy that can rationalize and individualize this therapeutic approach.

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