腎癌・前立腺癌に対する最新の薬物療法

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  • Updated systemic therapy for advanced/metastatic renal cell carcinoma and prostate cancer
  • ジンガン ゼンリツセンガン ニ タイスル サイシン ノ ヤクブツ リョウホウ

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As advanced renal cell carcinoma （RCC） shows resistance to anti-cancer drugs, immunotherapy had been the mainstay of systemic therapy. Recently, molecular targeted agents including VEGF and mTOR inhibitors have been introduced, and so systemic therapy for advanced RCC has been significantly altered. VEGF inhibitors show marked efficacy in regard to tumor size reduction, and the representative adverse events include hypertension, hand-foot syndrome, and hypothyroidism. mTOR inhibitors have modest effects for tumor size reduction, and the specific adverse events include stomatitis, hyperglycemia, hyperlipidemia, and interstitial pneumonia. The introduction of molecular targeted agents has improved survival in advanced RCC patients. Hormonal therapy is at the center of systemic therapy for advanced prostate cancer patients. Castration or LH-RH analogues suppress the proliferation of prostate cancer cells by decreasing androgen production in the testes. Anti-androgens inhibit the binding of testosterone to androgen receptors, and combination therapy of castration or LH-RH analogues and anti-androgens, called maximum androgen blockade, shows enhanced efficacy for advanced prostate cancer. Docetaxel is administered for castration-resistant prostate cancer, and prolongs survival compared to previously used anti-cancer drugs. Regarding new drugs for prostate cancer, an LH-RH antagonist, a CYP17 inhibitor of androgen production in the adrenal glands, and new anti-androgens with a higher affinity for androgen receptors have been developed for clinical use.

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