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  • 1 Szegedi Tudományegyetem, Általános Orvostudományi Kar Onkoterápiás Klinika Szeged Korányi fasor 12. 6720
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Az előrehaladott, világossejtes veserák kezelési palettája a molekuláris patológiai ismeretek szélesedése által új, célzott terápiás készítmények megjelenésével bővült. A magasan erezett vesedaganatok progressziójában központi szerepet játszik a daganat érújdonképződése, amelynek kulcsmolekulája a vascularis endothelnövekedési faktor, a modern targetszerek direkt vagy indirekt célpontja. A jelenleg törzskönyvezett készítmények hatásmechanizmusuk alapján a következő csoportokba sorolhatók: vascularis endothelnövekedési faktor ligandot blokkoló monoklonális antitestek (bevacizumab), a vascularis endothelnövekedési faktor receptorait gátló tirozinkináz-inhibitorok (sorafenib, sunitinib, pazopanib) vagy az intracelluláris jelátvitelben kulcsszerepet játszó mTOR-kináz-gátlók (temsirolimus, everolimus). Randomizált vizsgálatok alapján a nemzetközi ajánlások első vonalban sunitinib, pazopanib vagy interferon-α-bevacizumab kombinációt javasolnak jó és közepes prognózisú betegeknél, míg rossz prognózisúaknál temsiroli­must. A korábbi standard citokinterápia hatástalansága esetén sorafenib vagy pazopanib alkalmazható. Eredménytelen tirozinkináz-gátló terápiát követően jelenlegi ismereteink szerint az everolimuskezelés hatékonyságának bizonyítékai a legerősebbek. A betegek életkilátásai várhatóan folyamatosan javulni fognak a targetkészítmények spektrumának további bővülésével. Orv. Hetil., 2011, 152, 655–662.

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