Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press60410.17650/1726-9776-2016-12-3-22-29DIAGNOSIS AND TREATMENT OF URINARY SYSTEM TUMORS. RENAL CANCERДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ МОЧЕПОЛОВОЙ СИСТЕМЫ. Рак почкиOptimization of sequential targeted therapyОптимизация последовательной таргетной терапииAlekseevB. Ya.АлексеевБ. Я.
Russian Federation

3 2nd Botkinskiy Proezd, Moscow, 125284

Москва, 125284, 2-й Боткинский пр-д, 3 

KalpinskiyA. S.КалпинскийА. С.
Russian Federation

3 2nd Botkinskiy Proezd, Moscow, 125284

Москва, 125284, 2-й Боткинский пр-д, 3 

NyushkoK. M.НюшкоК. М.
Russian Federation

3 2nd Botkinskiy Proezd, Moscow, 125284

Москва, 125284, 2-й Боткинский пр-д, 3 

kirandja@ya.ruTarakiI. A.ТаракиИ. А.
Russian Federation

3 2nd Botkinskiy Proezd, Moscow, 125284

Москва, 125284, 2-й Боткинский пр-д, 3 

KaprinA. D.КапринА. Д.
Russian Federation

3 2nd Botkinskiy Proezd, Moscow, 125284

Москва, 125284, 2-й Боткинский пр-д, 3 

Moscow Research Oncological Institute named after P.A. Herzen – affiliated by the Federal State Budgetary Institution “National Medical Research Radiological Center”, Russian Ministry of HealthМосковский научно-исследовательский онкологический институт им. П.А. Герцена – филиал ФГБУ «Национальный медицинский исследовательский радиологический центр» Минздрава России3009201612322293009201630092016https://oncourology.abvpress.ru/oncur/article/view/604

Renal cell carcinoma (RCC) takes one of the leading places in the world incidence among malignant tumors of the genitourinary system. Metastatic renal cell cancer (mRCC) is detected in about 25–30 % of primary patients. 10 targeted immuno-oncology drugs for the treatment of mRCC were registered and approved for use from 2005 till the present time. Rapid growth of therapeutic options of mRCC treatment has created a problem for practicing oncologists and urologists as well as necessity to understand the principles and consistent optimization of targeted therapy to maximize the effectiveness of each treatment line. The article discusses issues of the correct choice of first-line targeted drugs, optimal dosing of sunitinib and aksitinib, alternative modes and alternating use of sunitinib, as well as the influence of objective response and hypertension, which developed on the background of the targeted therapy on the effectiveness of treatment. 

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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