治療轉移性腎細胞癌的新選擇－Pazopanib

New Choice for the Treatment of Metastatic Renal Cell Carcinoma-Pazopanib

姜紹青(Shao-Chin Chiang)

《腫瘤護理雜誌》 12卷2期 (2012/12) Pp. 19-23

https://doi.org/10.6880/TJON.201212_12(2).02

摘要

轉移性腎細胞癌的治療，長久以來以免疫治療為主，藥物的毒性大，但是療效不顯著。然而，因為對於von Hippel-Lindau（VHL）基因的瞭解，許多的標靶治療相應而生。血管內皮生長因子（vascular epithelial growth factor, VEGF）即是由於有缺陷的VHL基因無法控制而大量產生，可能進一步引起血管新生與腫瘤的生長與轉移。多重標的酪胺酸激酶抑制劑（sunitinib、sorafinib、pazopanib）已經在許多的臨床試驗中被證明它們在轉移性腎細胞癌的療效。Pazopanib為一個與酪胺酸激酶有高度接合能力的口服藥品，在經過免疫療法治療過的或是未經過治療的病人，其療效明顯地優於安慰劑；與標準治療sunitinib相比，也達到相似的結果，但是其副作用與生活品質則優於sunitinib。因此pazopanib已經在轉移性亮細胞腎細胞癌的治療上，與sunitinib並列為第一線治療選擇。

關鍵字

von Hippel-Lindau基因 ； 血管內皮生長因子

並列摘要

The treatment of the patients with metastatic renal cell carcinoma has primarily been used immunotherapy, which generates severe toxicities, but does not produce significant effects. Through the understanding of von Hippel-Lindau (VHL) gene, the target therapeutic agents subsequently developed. The vascular epithelial growth factors (VEGF) are produced by cancer cells because the defect VHL gene can not interrupt the pathway of hyoxemia, which promotes the proliferation and metastases of cancer cells, and then leads to the angiogenesis and tumor growth and metastasis. Several multi-target kinase inhibitors have been on market in Taiwan (e.g., sunitinib, sorafenib, and pazopanib) and their treatment effects on metastatic renal cell carcinoma had been proved in several clinical trials. Pazopanib is a potent inhibitor of tyrosin kinase which is the intracellualur part of vasucular epithelial growth factor receptors (VEGFR). As compared with placebo, the treatment effect of pazopanib is better in those metastatic renal cell carcinoma patients using immunotherapy, or not. In clinical trials, pazopanib has better effect than placebo, and similar progression free survival as sunitinib. However, the patients using pazopanib have better profile of adverse effects, and life quality than those using sunitinib. Therefore, pazopanib, a parallel with sunitinib is one of the first-line agents in treating patients with metastatic renal cell carcinoma.

並列關鍵字

von Hippel-Lindau gene ； vascular epithelial growth factor ； pazopanib