Primary and acquired resistance to first-line therapy for clear cell renal cell carcinoma.
Renal cell carcinoma
checkpoint inhibitors
resistance
target therapy
tumor microenvironment
Journal
Cancer drug resistance (Alhambra, Calif.)
ISSN: 2578-532X
Titre abrégé: Cancer Drug Resist
Pays: United States
ID NLM: 101738710
Informations de publication
Date de publication:
2023
2023
Historique:
received:
17
04
2023
revised:
26
06
2023
accepted:
11
07
2023
medline:
16
10
2023
pubmed:
16
10
2023
entrez:
16
10
2023
Statut:
epublish
Résumé
The introduction of first-line combinations had improved the outcomes for metastatic renal cell carcinoma (mRCC) compared to sunitinib. However, some patients either have inherent resistance or develop resistance as a result of the treatment. Depending on the kind of therapy employed, many factors underlie resistance to systemic therapy. Angiogenesis and the tumor immune microenvironment (TIME), nevertheless, are inextricably linked. Although angiogenesis and the manipulation of the tumor microenvironment are linked to hypoxia, which emerges as a hallmark of renal cell carcinoma (RCC) pathogenesis, it is only one of the potential elements involved in the distinctive intra- and inter-tumor heterogeneity of RCC that is still dynamic. We may be able to more correctly predict therapy response and comprehend the mechanisms underlying primary or acquired resistance by integrating tumor genetic and immunological markers. In order to provide tools for patient selection and to generate hypotheses for the development of new strategies to overcome resistance, we reviewed the most recent research on the mechanisms of primary and acquired resistance to immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs) that target the vascular endothelial growth factor receptor (VEGFR).We can choose patients' treatments and cancer preventive strategies using an evolutionary approach thanks to the few evolutionary trajectories that characterize ccRCC.
Identifiants
pubmed: 37842234
doi: 10.20517/cdr.2023.33
pmc: PMC10571064
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
517-546Informations de copyright
© The Author(s) 2023.
Déclaration de conflit d'intérêts
SA declares no conflicts of interest. FA is a consultant/member of the external advisory board for Pfizer, BMS, Ipsen, MSD, AstraZeneca, Merck and Accord.
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