Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press58510.17650/1726-9776-2016-12-4-35-42DIAGNOSIS AND TREATMENT OF URINARY SYSTEM TUMORS. RENAL CANCERДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ МОЧЕПОЛОВОЙ СИСТЕМЫ. Рак почкиA new alternating regimen in metastatic renal cell carcinoma presented through a clinical caseНовый альтернирующий режим при метастатическом почечно-клеточном раке на примере клинического случаяSayapinaM. S.СаяпинаМ. С.
Russian Federation

23 Kashirskoe Shosse, Moscow 115478

115478 Москва, Каширское шоссе, 23

maria.sayapina@mail.ruShiryaevS. V.ШиряевС. В.
Russian Federation

23 Kashirskoe Shosse, Moscow 115478

115478 Москва, Каширское шоссе, 23

maria.sayapina@mail.ruKrylovA. S.КрыловА. С.
Russian Federation

23 Kashirskoe Shosse, Moscow 115478

115478 Москва, Каширское шоссе, 23

maria.sayapina@mail.ruRyzhkovA. D.РыжковА. Д.

23 Kashirskoe Shosse, Moscow 115478

115478 Москва, Каширское шоссе, 23

TitovD. A.ТитовД. А.

23 Kashirskoe Shosse, Moscow 115478

115478 Москва, Каширское шоссе, 23

NosovD. A.НосовД. А.
Russian Federation

15 Marshala Timoshenko St., Moscow 121359

121359 Москва, ул. Маршала Тимошенко, 15

nosov@mail.ruN.N. Blokhin Russian Cancer Research Center, Ministry of Health of RussiaФГБУ «Российский онкологический научный центр им. Н.Н. Блохина» Минздрава РоссииCentral Clinical Hospital, Administration of President of RussiaФГБУ «Центральная клиническая больница с поликлиникой» Управления делами Президента России3012201612435422706201618102016https://oncourology.abvpress.ru/oncur/article/view/585

In the article a new alternating regimen which includes alternation between interferon (INF) immunotherapy and target therapy (sunitinib) is described through a clinical case. Mentions of this type of regimen weren’t found in the literature. As a result of the regimen, treatment efficacy increased due to decreased development of resistance to targeted therapy, cumulative toxicity decreased, synergy between immunotherapy and targeted therapy was achieved, and the cost of the treatment was reduced by 50 %. Considering the above, other alternating regimens can be of interest for researchers: INF/targeted therapies (INF/axitinib, et al.), checkpoint inhibitors/targeted therapies. At the same time, randomized phase II trial ROPETAR showed that alternation of targeted therapies (pazopanib/everolimus) does not increase treatment efficacy or decrease toxicity in comparison with sequential dosing.

В данной статье на примере клинического случая описан новый альтернирующий режим, включающий чередование иммунотерапии интерфероном (INF) и таргетной терапии (сунитиниб). В литературе сведения о таком режиме не найдены. В результате его применения удалось повысить эффективность лечения за счет снижения развития резистентности к таргетной терапии, уменьшения кумулятивной токсичности, синергизма иммунотерапии и таргетной терапии, а также снизить стоимость курса лечения до 50 %. С учетом вышеизложенного интерес может представлять изучение других альтернирующих режимов: INF/таргетные препараты (INF/акситиниб и др.), ингибиторы чекпоинтов/таргетные препараты. При этом, по результатам рандомизированного исследования II фазы ROPETAR, чередование таргетных препаратов (пазопаниб/эверолимус) не привело к повышению эффективности терапии и снижению токсичности по сравнению с последовательным назначением.

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