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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="other" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Cancer Urology</journal-id><journal-title-group><journal-title xml:lang="en">Cancer Urology</journal-title><trans-title-group xml:lang="ru"><trans-title>Онкоурология</trans-title></trans-title-group></journal-title-group><issn publication-format="print">1726-9776</issn><issn publication-format="electronic">1996-1812</issn><publisher><publisher-name xml:lang="en">Publishing House ABV Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">879</article-id><article-id pub-id-type="doi">10.17650/1726-9776-2018-14-3-25-36</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>DIAGNOSIS AND TREATMENT OF URINARY SYSTEM TUMORS. RENAL CANCER</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>ДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ МОЧЕПОЛОВОЙ СИСТЕМЫ. Рак почки</subject></subj-group><subj-group subj-group-type="article-type"><subject></subject></subj-group></article-categories><title-group><article-title xml:lang="en">CURRENTLY AVAILABLE TREATMENT OPTIONS FOR METASTATIC RENAL CELL CARCINOMA</article-title><trans-title-group xml:lang="ru"><trans-title>СОВРЕМЕННЫЕ ВОЗМОЖНОСТИ ЛЕЧЕНИЯ МЕТАСТАТИЧЕСКОГО ПОЧЕЧНО-КЛЕТОЧНОГО РАКА</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3398-4128</contrib-id><name-alternatives><name xml:lang="en"><surname>Alekseev</surname><given-names>B. Ya.</given-names></name><name xml:lang="ru"><surname>Алексеев</surname><given-names>Б. Я.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Build. 4, 51 3rd Parkovaya St., Moscow 105425.</p></bio><bio xml:lang="ru"><p>105425 Москва, ул. 3-я Парковая, 51, корп. 4.</p></bio><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8784-8415</contrib-id><name-alternatives><name xml:lang="en"><surname>Kaprin</surname><given-names>A. D.</given-names></name><name xml:lang="ru"><surname>Каприн</surname><given-names>А. Д.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Build. 4, 51 3rd Parkovaya St., Moscow 105425.</p></bio><bio xml:lang="ru"><p>105425 Москва, ул. 3-я Парковая, 51, корп. 4.</p></bio><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Kolesnikov</surname><given-names>G. P.</given-names></name><name xml:lang="ru"><surname>Колесников</surname><given-names>Г. П.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>6 Staropetrovskiy Proezd, Moscow 125130.</p></bio><bio xml:lang="ru"><p>125130 Москва, Старопетровский проезд, 6.</p></bio><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Mukhomed’yarova</surname><given-names>A. A.</given-names></name><name xml:lang="ru"><surname>Мухомедьярова</surname><given-names>А. А.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>3 2nd Botkinskiy Proezd, Moscow 125284.</p></bio><bio xml:lang="ru"><p>125284 Москва, 2-й Боткинский проезд, 3.</p></bio><xref ref-type="aff" rid="aff6"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Konopleva</surname><given-names>E. I.</given-names></name><name xml:lang="ru"><surname>Коноплева</surname><given-names>Е. И.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>1 Leninskie Gory, Moscow 119991.</p></bio><bio xml:lang="ru"><p>119991 Москва, Ленинские горы, 1.</p></bio></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2209-3020</contrib-id><name-alternatives><name xml:lang="en"><surname>Kalpinskiy</surname><given-names>A. S.</given-names></name><name xml:lang="ru"><surname>Калпинский</surname><given-names>А. С.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>3 2nd Botkinskiy Proezd, Moscow 125284.</p></bio><bio xml:lang="ru"><p>125284 Москва, 2-й Боткинский проезд, 3.</p></bio><email>dr.Kalpinskiy@rambler.ru</email><xref ref-type="aff" rid="aff6"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">N.A. Lopatkin Research Institute of Urology and Interventional Radiology – branch of the National Medical Research Center of Radiology, Ministry of Health of Russia</institution></aff><aff><institution xml:lang="ru">Научно-исследовательский институт урологии и интервенционной радиологии им. Н.А. Лопаткина – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава России</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Moscow City Oncology Hospital No. 62, Moscow Healthcare Department</institution></aff><aff><institution xml:lang="ru">ГБУЗ г. Москвы «Московская городская онкологическая больница № 62 Департамента здравоохранения г. Москвы»</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="ru"></institution></aff><aff><institution xml:lang="en">P.A. Hertzen Moscow Oncology Research Institute – branch of the National Medical Research Center of Radiology, Ministry of Health of Russia</institution></aff></aff-alternatives><aff-alternatives id="aff4"><aff><institution xml:lang="ru">Московский научно-исследовательский онкологический институт им. П.А. Герцена – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава России</institution></aff><aff><institution xml:lang="en">M.V. Lomonosov Moscow State University</institution></aff></aff-alternatives><aff-alternatives id="aff5"><aff><institution xml:lang="ru">ФГБОУ ВО «Московский государственный университет им. М.В. Ломоносова»</institution></aff><aff><institution xml:lang="en">P.A. Hertzen Moscow Oncology Research Institute – branch of the National Medical Research Center of Radiology, Ministry of Health of Russia</institution></aff></aff-alternatives><aff id="aff6"><institution>Московский научно-исследовательский онкологический институт им. П.А. Герцена – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава России</institution></aff><pub-date date-type="pub" iso-8601-date="2018-09-30" publication-format="electronic"><day>30</day><month>09</month><year>2018</year></pub-date><volume>14</volume><issue>3</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>25</fpage><lpage>36</lpage><history><date date-type="received" iso-8601-date="2018-10-02"><day>02</day><month>10</month><year>2018</year></date><date date-type="accepted" iso-8601-date="2018-10-02"><day>02</day><month>10</month><year>2018</year></date></history><permissions><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/></permissions><self-uri xlink:href="https://oncourology.abvpress.ru/oncur/article/view/879">https://oncourology.abvpress.ru/oncur/article/view/879</self-uri><abstract xml:lang="en"><p>Over the last 10 years, the capacities of second-line systemic therapy for metastatic renal cell carcinoma (mRCC) changed significantly. Targeted therapy is a standard treatment for patients with mRCC. However, the choice of therapeutic agents for such patients remains challenging. In the absence of reliable prognostic biomarkers, physicians can use only the results of randomized clinical trials and their own routine experience with targeted drugs when choosing a regimen of second-line therapy. The article discusses the current situation with second-line therapy with the three new options available for patients with mRCC. It also contains a case report, describing our successful experience of treatment a female patient that received 6 variants of chemotherapy with good effect during 89 months after the diagnosis.</p></abstract><trans-abstract xml:lang="ru"><p>За последние 10 лет существенно изменились возможности 2-й линии системной терапии метастатического почечно-клеточного рака (мПКР). Стандартным методом лечения пациентов, страдающих мПКР, является таргетная терапия. Выбор препаратов для таких больных остается сложной задачей. При отсутствии надежных прогностических и предикторных биомаркеров специалисты при выборе тактики 2-й линии терапии рака почки могут ориентироваться только на результаты рандомизированных клинических  исследований и собственный опыт применения таргетных препаратов в условиях рутинной клинической практики. В статье освещается современное состояние проблемы 2-й линии терапии с появлением 3 новых доступных опций для лечения больных мПКР и представляется успешный клинический  случай пациентки,  получившей 6 вариантов лекарственной терапии с хорошим эффектом на протяжении 89 мес после установления диагноза.</p></trans-abstract><kwd-group xml:lang="en"><kwd>renal cancer</kwd><kwd>lenvatinib</kwd><kwd>metastatic renal cell carcinoma</kwd><kwd>targeted therapy</kwd><kwd>tyrosine kinase inhibitor</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>рак почки</kwd><kwd>ленватиниб</kwd><kwd>метастатический почечно-клеточный рак</kwd><kwd>таргетная терапия</kwd><kwd>ингибитор тирозинкиназ</kwd></kwd-group><funding-group><funding-statement xml:lang="en">Eisai Co., Ltd.</funding-statement><funding-statement xml:lang="ru">Компания «Эйсай»</funding-statement></funding-group></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>International Agency for Research on Cancer. 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