POSSIBILITIES OF ORGAN-PRESERVING TREATMENT OF PATIENTS WITH MULTIPLE RENAL TUMORS

Renal cell carcinoma (RCC) occupies one of the leading places in the world for morbidity among malignant neoplasms of the genitourinary system. The frequency of occurrence of bilateral RCC according to different authors is 2–6% of the total population of patients with RCC. Currently, the only effective method of treatment of bilateral RCC is surgical treatment. Patients with bilateral RCC are at high risk of dev eloping of local recurrence or progression of the disease after organ-preserving surgeries, which is why the surgeon is faced with a choice between a high risk of developing renal failure or relapse and/or progression of the disease, depending on the extent of the surgical intervention. According to the literature, in patients with bilateral RCC there was an increase in the incidence of papillary variant of RCC up to 19% and the presence of multifocal lesion. Surgical treatment of bilateral RCC is the only effective method to achieve satisfactory oncological results at a low incidence of complications. The m ost justified option for the treatment of bilateral RCC is the implementation of bilateral organ-preserving treatment, which allows achieving the optimal functional results. This article presents a clinical case of successful surgical treatment of a patient with bilateral RCC with multiple tumors

Таргетная терапия больных метастатическим раком почки неблагоприятного прогноза

The majority of patients with metastatic renal cell carcinoma (mRCC) are in the groups of favorable or moderate prognosis per the MSKCC (MemorialSloan-KetteringCancerCenter) criteria, but in 20–30 % of poor-prognosis patients aggressive, rapidly progressing mRCC is observed. Despite improved prognosis in mRCC patients due to targeted therapy, this patient group remains hard to treat with overall survival 6 months) was higher in the temsirolimus (32.1 %) and combination (28.1 %) groups compared to the IFN-α group (15.5 %; р<0,001).Большинство больных метастатическим почечно-клеточным раком (мПКР) относятся к группе благоприятного и промежуточного прогноза согласно критериям шкалы MSKCC (Memorial Sloan-Kettering Cancer Center), однако у 20–30 % пациентов с неблагоприятным прогнозом регистрируется агрессивный, быстро прогрессирующий мПКР. Несмотря на улучшение прогноза заболевания у больных мПКР на фоне таргетной терапии, эта категория пациентов остается трудно поддающейся лечению, а показатели общей выживаемости составляют 6 мес) оказалась выше в группах темсиролимуса (32,1 %) и комбинированного лечения (28,1 %), чем в группе ИФН-α (15,5 %; р<0,001).

СОВРЕМЕННЫЕ ВОЗМОЖНОСТИ ЛЕЧЕНИЯ МЕТАСТАТИЧЕСКОГО ПОЧЕЧНО-КЛЕТОЧНОГО РАКА

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.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

Targeted therapy in patients with poor-prognosis renal cell carcinoma

The majority of patients with metastatic renal cell carcinoma (mRCC) are in the groups of favorable or moderate prognosis per the MSKCC (MemorialSloan-KetteringCancerCenter) criteria, but in 20–30 % of poor-prognosis patients aggressive, rapidly progressing mRCC is observed. Despite improved prognosis in mRCC patients due to targeted therapy, this patient group remains hard to treat with overall survival 6 months) was higher in the temsirolimus (32.1 %) and combination (28.1 %) groups compared to the IFN-α group (15.5 %; р<0,001)

CURRENTLY AVAILABLE TREATMENT OPTIONS FOR METASTATIC RENAL CELL CARCINOMA

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