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La guérison du cancer du rein métastasique est-elle envisageable?

  • Bernard Escudier
Chapter
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Part of the Oncologie pratique book series (ONCOLPRAT)

Abstrait

Les progrès thérapeutiques accomplis au cours des dernières années dans la prise en charge du cancer du rein métastatique (CRM) ont indiscutablement permis de prolonger la durée de vie des patients. La survie médiane, classiquement estimée autour de 1 an dans les années 1990 (1, 2, 3, 4), atteint actuellement plutôt 20 à 24 mois. Cette amélioration est certainement liée à ľefficacité des nouveaux traitements, sunitinib (5), sorafénib (6) ou temsirolimus (7), mais est aussi liée à ľévolution naturelle de la maladie. Il est en effet utile de rappeler que ľévolution naturelle des CRM est aussi modifiée par la survenue, certes rare mais non exceptionnelle (autour de 5 %), de rémissions spontanées, parfois durables (8). Il est donc naturel de se poser la question de la guérison des CRM.

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Références

  1. 1.
    Motzer RJ, Mazumdar M, Bacik J et al. (1999) Survival and prognostic stratification of 670 patients with advanced renal cell carcinoma. J Clin Oncol 17: 2530–40PubMedGoogle Scholar
  2. 2.
    MRC trial (1999) Interferon-alpha and survival in metastatic renal carcinoma: early results of a randomised controlled trial. Medical Research Council Renal Cancer Collaborators. Lancet 353: 14–7CrossRefGoogle Scholar
  3. 3.
    Flanigan RC, Salmon SE, Blumenstein BA et al. (2001) Nephrectomy followed by interferon alfa-2b compared with interferon alfa-2b alone for metastatic renal-cell cancer. N Engl J Med 345: 1655–9PubMedCrossRefGoogle Scholar
  4. 4.
    Négrier S, Escudier B, Gomez F et al. (2002) Prognostic factors of survival and rapid progression in 782 patients with metastatic renal carcinomas treated by cytokines: a report from the groupe français ďimmunothérapie. Ann Oncol 13: 1460–8PubMedCrossRefGoogle Scholar
  5. 5.
    Motzer RJ, Hutson TE, Tomczak P et al. (2007) Phase III randomized trial of sunitinib malate (SU11248) versus interferon-alfa as first-line systemic therapy for patients with metastatic renal cell carcinoma. N Engl J Med 356: 115–24PubMedCrossRefGoogle Scholar
  6. 6.
    Escudier B, Eisen T, Stadler WM et al. (2007) Treatment Approaches in Renal cancer Global Evaluation Trial (TARGETs): A Randomized, Double-Blind, Placebo-Controlled Phase III Trial of Sorafenib, an Oral Multi-Kinase Inhibitor in Advanced Renal Cell Carcinoma. N Engl J Med 356: 125–34PubMedCrossRefGoogle Scholar
  7. 7.
    Hudes G, Carducci M, Tomczak P et al. Temsirolimus, interferon alfa or both for advanced renal cell carcinoma. N Engl J Med 356: 2271–81Google Scholar
  8. 8.
    Gleave ME, Elihali M, Frader Y et al. (1998) Interferon gamma-1b compared with placebo in metastatic renal cell carcinoma. N Engl J Med 338: 1272–8CrossRefGoogle Scholar
  9. 9.
    Mickisch GH, Garin A, van Poppel H et al. (2001) European Organisation for Research and Treatment of Cancer (EORTC) Genitourinary Group. Radical nephrectomy plus interferon-alfa-based immunotherapy compared with interferon alfa alone in metastatic renal-cell carcinoma: a randomised trial. Lancet 358: 966–70PubMedCrossRefGoogle Scholar
  10. 10.
    Pantuck AJ, Belldegrun AS, Figlin RA (2007) Cytoreductive nephrectomy for metastatic renal cell carcinoma: is it still imperative in the era of targeted therapy? Clin Cancer Res 13: 693s–696sPubMedCrossRefGoogle Scholar
  11. 11.
    Kim B, Louie AC (1992) Surgical resection following interleukin 2 therapy for metastatic renal cell carcinoma prolongs remission. Arch Surg 127: 1343–9PubMedGoogle Scholar
  12. 12.
    Rasco DW, Assikis V, Marshall F (2006) Integrating metastasectomy in the management of advanced urological malignancies-where are we in 2005? J Urol 176: 1921–6PubMedCrossRefGoogle Scholar
  13. 13.
    Vogl UM, Zehetgruber H, Dominkus M et al. (2006) Prognostic factors in metastatic renal cell carcinoma: metastasectomy as independent prognostic variable. Br J Cancer 95: 691–8PubMedCrossRefGoogle Scholar
  14. 14.
    Marulli G, Sartori F, Bassi PF et al. (2006) Long-term results of surgical management of pulmonary metastases from renal cell carcinoma. Thorac Cardiovasc Surg 54: 544–7PubMedCrossRefGoogle Scholar
  15. 15.
    Rini BI, Shaw V, Rosenberg JE et al. (2006) Patients with metastatic renal cell carcinoma with long-term disease-free survival after treatment with sunitinib and resection of residual metastases. Clin Genitourin Cancer 5: 232–4PubMedCrossRefGoogle Scholar
  16. 16.
    Rini BI, Campbell SC (2007) The evolving role of surgery for advanced renal cell carcinoma in the era of molecular targeted therapy. J Urol 177: 1978–84PubMedCrossRefGoogle Scholar
  17. 17.
    Rosenberg SA, Lotze MT, Muul LM et al. (1985) Observations on the systemic administration of autologous lymphokine-activated killer cells and recombinant interleukin-2 to patients with metastatic cancer. N Engl J Med 313: 1485–92PubMedGoogle Scholar
  18. 18.
    Mc Dermott DF (2007) Update on the application of interleukin-2 in the treatment of renal cell carcinoma. Clin Cancer Res 13: 716s–720sCrossRefGoogle Scholar
  19. 19.
    Childs R, Chernoff A, Contentin N et al. (2000) Regression of metastatic renal-cell carcinoma after nonmyeloablative allogeneic peripheral-blood stem-cell transplantation. N Engl J Med 343: 750–8PubMedCrossRefGoogle Scholar
  20. 20.
    Yang JC, Childs R (2006) Immunotherapy for renal cell cancer. J Clin Oncol 24: 5576–83PubMedCrossRefGoogle Scholar
  21. 21.
    Négrier S, Escudier B, Lasset C et al. (1998) Interleukin-2, interferon or both in 425 patients with metastatic renal cell cancer: results of a multicenter randomized trial. N Engl J Med 338: 1272–8PubMedCrossRefGoogle Scholar
  22. 22.
    Bergerat JP, Herbrecht R, Dufour P et al. (1998) Combination of recombinant interferon alpha 2a and vinblastine in advanced renal cell cancer. Cancer 62: 2320–4CrossRefGoogle Scholar
  23. 23.
    Upton MP, Parker RA, Youmans A et al. (2005) Histologic predictors of renal cell carcinoma response to interleukin-2-based therapy. J Immunother 28: 488–95PubMedCrossRefGoogle Scholar
  24. 24.
    Kim HL, Seligson D, Liu X et al. (2005) Using tumor markers to predict the survival of patients with metastatic renal cell carcinoma. J Urol 173: 1496–501PubMedCrossRefGoogle Scholar
  25. 25.
    Merchan JR, Pitot HC, Liu G et al. (2007) Phase I/II Trial of CCI-779 and Bevacizumab in Advanced Renal Cell Cancer: Phase I results. J Clin Oncol Proc ASCO 25: 243s, abstr 5034Google Scholar
  26. 26.
    Amato RJ, Harris P, Dalton M et al. (2007) A phase II trial of intra-patient dose-escalated sorafenib in patients (pts) with metastatic renal cell carcinoma (MRCC). J Clin Oncol, 2007 ASCO Annual Meeting Proceedings Part I. Vol 25, No. 18S (June 20 Supplement): 5026Google Scholar
  27. 27.
    Rini BI, Wilding GT, Hudes G et al. (2007) Axitinib (AG-013736; AG) in patients (pts) with metastatic renal cell cancer (RCC) refractory to sorafenib. J Clin Oncol 2007 ASCO Annual Meeting Proceedings Part I. Vol 25, No. 18S (June 20 Supplement): 5032Google Scholar
  28. 28.
    Hutson TE, Davis ID, Machiels JP et al. (2007) Pazopanib (GW786034) is active in metastatic renal cell carcinoma (RCC): Interim results of a phase II randomized discontinuation trial (RDT). J Clin Oncol 2007 ASCO Annual Meeting Proceedings Part I. Vol 25, No. 18S (June 20 Supplement): 5031Google Scholar

Copyright information

© Springer-Verlag France, Paris 2008

Authors and Affiliations

  • Bernard Escudier
    • 1
  1. 1.Institut Gustave Roussy VillejuifVillejuifFrance

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