文章：

变异组织学肾细胞癌的免疫疗法与新型疗法

Immune-Based and Novel Therapies in Variant Histology Renal Cell Carcinomas

原文发布日期：20 January 2025

DOI: 10.3390/cancers17020326

类型: Article

开放获取: 是

英文摘要：

Renal cell carcinoma (RCC) is a heterogeneous disease that represents the most common type of kidney cancer. The classification of RCC is primarily based on distinct morphological and molecular characteristics, with two broad categories: clear cell RCC (ccRCC) and non-clear cell RCC (nccRCC). Clear cell RCC is the predominant subtype, representing about 70–80% of all RCC cases, while non-clear cell subtypes collectively make up the remaining 20–30%. Non-clear cell RCC encompasses many histopathological variants, each with unique biological and clinical characteristics. Additionally, any RCC subtype can undergo sarcomatoid dedifferentiation, which is associated with poor prognosis and rapid disease progression. Recent advances in molecular profiling have also led to the identification of molecularly defined variants, further highlighting the complexity of this disease. While immunotherapy has shown efficacy in some RCC variants and subpopulations, significant gaps remain in the treatment of rare subtypes. This review explores the outcomes of immunotherapy across RCC subtypes, including rare variants, and highlights opportunities for improving care through novel therapies, biomarker-driven approaches, and inclusive clinical trial designs.

摘要翻译： 

肾细胞癌是一种异质性疾病，是最常见的肾癌类型。其分类主要基于独特的形态学和分子特征，可分为两大类别：透明细胞肾细胞癌和非透明细胞肾细胞癌。透明细胞肾细胞癌是主要亚型，约占所有肾细胞癌病例的70-80%，而非透明细胞亚型共占剩余的20-30%。非透明细胞肾细胞癌包含多种组织病理学变异型，每种都具有独特的生物学和临床特征。此外，任何肾细胞癌亚型都可能发生肉瘤样去分化，这与不良预后和疾病快速进展相关。分子谱分析的最新进展也促使了分子定义变异型的识别，进一步凸显了该疾病的复杂性。虽然免疫疗法在某些肾细胞癌变异型和亚群中显示出疗效，但在罕见亚型的治疗方面仍存在显著差距。本综述探讨了免疫疗法在不同肾细胞癌亚型（包括罕见变异型）中的疗效，并强调了通过新型疗法、生物标志物驱动方法以及包容性临床试验设计来改善治疗效果的机遇。

原文链接：

Immune-Based and Novel Therapies in Variant Histology Renal Cell Carcinomas