Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press136010.17650/1726-9776-2020-16-3-29-37DIAGNOSIS AND TREATMENT OF URINARY SYSTEM TUMORS. RENAL CANCERДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ МОЧЕПОЛОВОЙ СИСТЕМЫ. Рак почкиCombination of pembrolizumab and axitinib: a new gold standard in the first-line therapy for metastatic clear-cell renal-cell carcinoma?Комбинация пембролизумаб + акситиниб: новый «золотой стандарт» в 1-й линии при метастатическом светлоклеточном почечно-клеточном раке?https://orcid.org/0000-0002-7592-0392GafanovR. A.ГафановР. А.
Russian Federation

86 Profsoyuznaya St., Moscow 117997.

Гафанов Рустем Айратович.117997 Москва, ул. Профсоюзная, 86.

docgra@mail.ruhttps://orcid.org/0000-0001-5789-375XDzidzariaA. G.ДзидзарияА. Г.
Russian Federation

86 Profsoyuznaya St., Moscow 117997.

117997 Москва, ул. Профсоюзная, 86.

https://orcid.org/0000-0003-1671-369XKravtsovI. B.КравцовИ. Б.
Russian Federation

86 Profsoyuznaya St., Moscow 117997.

117997 Москва, ул. Профсоюзная, 86.

https://orcid.org/0000-0002-8665-3103FastovetsS. V.ФастовецС. В.
Russian Federation

86 Profsoyuznaya St., Moscow 117997.

117997 Москва, ул. Профсоюзная, 86.

Russian Scientific Center of Roentgen Radiology, Ministry of Health of RussiaРоссийский научный центр рентгенорадиологии Минздрава России3009202016329371711202017112020https://oncourology.abvpress.ru/oncur/article/view/1360

The treatment strategy for metastatic renal cell carcinoma (mRCC) has evolved with the emergence of anti-angiogenic drugs, in particular tyrosine kinase inhibitors (TKIs) targeting the vascular endothelial growth factor receptor (VEGFR) and immune checkpoint inhibitors (ICIs). Both treatment options improved patient outcomes and altered the natural history of mRCC. Clinical studies have focused on evaluating combination regimens containing ICI and VEGFR-targeted TKIs. The combination of axitinib with pembrolizumab (KEYNOTE-426) showed better results compared to sunitinib in patients with mRCC who had not previously received systemic therapy. In this article, we discuss the rationale for the combination of ICI and TKI based on preclinical data, as well as the clinical results obtained with the combination of axitinib with pembrolizumab in first-line patients in clinical trials.

Стратегия лечения метастатического почечно-клеточного рака (мПКР) трансформировалась с появлением антиангиогенных препаратов, в частности ингибиторов тирозинкиназы (TKI), нацеленных на рецептор фактора роста эндотелия сосудов (VEGFR), и ингибиторов иммунных контрольных точек (ICI). Оба варианта лечения улучшили прогноз заболевания и изменили естественное течение мПКР. Клинические исследования были сосредоточены на оценке комбинированных схем, содержащих ICI и VEGFR-направленные TKI. Комбинация акситиниба с пембролизумабом (исследование KEYNOTE-426) показала лучшие результаты по сравнению с сунитинибом у пациентов с мПКР, не получавших ранее системную терапию. В настоящей статье обсуждены обоснование комбинации ICI и TKI на основе доклинических данных, а также клинические результаты, полученные при использовании комбинации акситиниба с пембролизумабом в 1-й линии терапии в клинических исследованиях при мПКР.

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