medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-22-65-72medsovet-7250Research ArticleОНКОУРОЛОГИЯONCOUROLOGYРеактуализация сунитиниба в терапии метастатического почечно-клеточного ракаReactualization of sunitinib in the treatment of metastatic renal cell carcinomahttps://orcid.org/0000-0002-5160-925XГрицкевичА. А.GritskevichA. A.

Грицкевич Александр Анатольевич - доктор медицинских наук, заведующий отделением урологии, Национальный медицинский исследовательский центр хирургии имени А.В. Вишневского; профессор кафедры урологии и оперативной нефрологии с курсом онкоурологии Медицинского института, Российский университет дружбы народов.

117997, Москва, ул. Большая Серпуховская, д. 27; 117198, Москва, ул. Миклухо-Маклая, д. 6

Alexander A. Gritskevich - Dr. Sci. (Med.), Head of the Department of Urology, Vishnevsky National Medical Research Center of Surgery; Professor of the Department of Urology and Operative Nephrology with a Course of Oncourology at the Medical Institute, Peoples' Friendship University of Russia.

27, Bolshaya Serpukhovskaya St., Moscow, 117997; 6, Miklukho-Maklai St., Moscow, 117198

grekaa@mail.ruhttps://orcid.org/0000-0002-3646-1664БайтманТ. П.BaitmanT. P.

Байтман Татьяна Павловна - научный сотрудник отделения урологии, Национальный медицинский исследовательский центр хирургии имени А.В. Вишневского.

117997, Москва, ул. Большая Серпуховская, д. 27

Tatiana P. Baitman - Researcher, Department of Urology, Vishnevsky National Medical Research Center of Surgery.

27, Bolshaya Serpukhovskaya St., Moscow, 117997

bit.t@mail.ruhttps://orcid.org/0000-0001-6267-8237ПоповА. Ю.PopovA. Yu.

Попов Анатолий Юрьевич - кандидат медицинских наук, заведующий отделением химиотерапии.

117997, Москва, ул. Большая Серпуховская, д. 27

Anatoly Yu. Popov - Cand. Sci. (Med.), Head of the Department of Chemotherapy, A Vishnevsky National Medical Research Center of Surgery.

27, Bolshaya Serpukhovskaya St., Moscow, 117997

popov_63@mail.ruhttps://orcid.org/0000-0002-0945-2498РусаковИ. Г.RusakovI. G.

Русаков Игорь Георгиевич – доктор медицинских наук, профессор, заместитель главного врача по онкологии.

105077, Москва, ул. 11-я Парковая, д. 32

Igor G. Rusakov - Dr. Sci. (Med.), Professor, Deputy Chief Physician for Oncology, Pletnev City Clinical Hospital.

32, 11th Parkovaya St., Moscow, 105077

igorrusakov@mail.ruhttps://orcid.org/0000-0001-8723-8916КарельскаяН. А.KarelskayaN. A.

Карельская Наталья Александровна – кандидат медицинских наук, старший научный сотрудник отдела лучевой диагностики.

117997, Москва, ул. Большая Серпуховская, д. 27

Natalia A. Karelskaya - Cand. Sci. (Med.), Senior Researcher, Department of Radiation Diagnostics, Vishnevsky National Medical Research Center of Surgery.

27, Bolshaya Serpukhovskaya St., Moscow, 117997

karelskaya.n@yandex.ruhttps://orcid.org/0000-0001-8066-2626ЧевинаА. А.ChevinaA. A.

Чевина Алина Андреевна - врач - анестезиолог-реаниматолог, отдел анестезиологии-реанимации.

117997, Москва, ул. Большая Серпуховская, д. 27

Alina A. Chevina - Anesthesiologist-Resuscitator, Department of Anesthesiology-Resuscitation, Vishnevsky National Medical Research Center of Surgery.

27, Bolshaya Serpukhovskaya St., Moscow, 117997

a.chevina@mail.ruhttps://orcid.org/0000-0002-2424-0493ЖолболдуП.ZholbolduP.

Жолболду Полотбек уулу - младший научный сотрудник, врач-уролог отделения урологии.

117997, Москва, ул. Большая Серпуховская, д. 27

Zholboldu Polotbek uulu - Junior Researcher, Urologist, Department of Urology, Vishnevsky National Medical Research Center of Surgery.

27, Bolshaya Serpukhovskaya St., Moscow, 117997

jolboldu94.01@gmail.comНациональный медицинский исследовательский центр хирургии имени А.В. Вишневского; Российский университет дружбы народовРоссияVishnevsky National Medical Research Center of Surgery; Peoples' Friendship University of RussiaRussian FederationНациональный медицинский исследовательский центр хирургии имени А.В. ВишневскогоРоссияVishnevsky National Medical Research Center of SurgeryRussian FederationГородская клиническая больница имени Д.Д. ПлетневаРоссияPletnev City Clinical HospitalRussian Federation2022071220220226572Copyright © Грицкевич А.А., Байтман Т.П., Попов А.Ю., Русаков И.Г., Карельская Н.А., Чевина А.А., Жолболду П., 20222022Грицкевич А.А., Байтман Т.П., Попов А.Ю., Русаков И.Г., Карельская Н.А., Чевина А.А., Жолболду П.Gritskevich A.A., Baitman T.P., Popov A.Y., Rusakov I.G., Karelskaya N.A., Chevina A.A., Zholboldu P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7250

За последние годы подход к лечению распространенного почечно-клеточного рака (ПКР) претерпел значительные изменения. Внедрение в 2000-е гг. таргетных препаратов в системную терапию ПКР, начавшееся с ингибиторов тирозинкиназ, пришедших на смену цитокинам, произвело революционный эффект. Затем терапевтический арсенал был расширен за счет введения дублетов, состоящих из комбинации ингибиторов иммунных контрольных точек или ингибиторов иммунных контрольных точек и ингибиторов тирозинкиназ. Сегодня ведущие позиции по эффективности лечения метастатического ПКР (мПКР) занимает двойная терапия - преимущественно сочетание иммунных и таргетных препаратов, однако по ряду причин монотерапия ингибиторами тирозинкиназ сохраняет актуальность. Ингибиторы тирозинкиназ по-прежнему представляют собой действенный вариант лечения мПКР, сохраняя свои позиции в первой линии терапии пациентов благоприятного прогноза. По данным исследования CheckMate, таргетная терапия обладает высокой эффективностью, а частота развития осложнений, как правило, ниже, чем при терапии комбинацией ниволумаба и ипилимумаба. В отличие от двойной иммунотерапии, сунитиниб не подвергает пациентов благоприятного прогноза неоправданному риску нежелательных побочных явлений, при этом оставляет больше вариантов для последующих линий терапии, обладает фармакоэкономическим преимуществом. Представленное клиническое наблюдение является примером успешной монотерапии сунитинибом ранее не леченного пациента с мПКР благоприятного прогноза. Данный случай представляет особый интерес в связи с поражением единственной почки и полиморбидностью пациента. Эффективная таргетная терапия в послеоперационном периоде благоприятно повлияла на качество и продолжительность жизни.

In recent years, the approach to the treatment of advanced renal cell carcinoma (RCC) has undergone significant changes. The introduction of targeted drugs in the systemic therapy of RCC in the 2000s began with tyrosine kinase inhibitors that replaced cytokines and had a revolutionary effect. Then the therapeutic arsenal was expanded with the introduction of doublets consisting of a combination of immune checkpoint inhibitors or immune checkpoint inhibitors and tyrosine kinase inhibitors. Tyrosine kinase inhibitors continue to represent an effective treatment option for metastatic RCC (mRCC), maintaining their position as first-line therapy in patients with a favorable prognosis. According to the CheckMate study, targeted therapy is highly effective, and the incidence of complications is generally lower than with nivolumab/ipilimumab combination therapy. Unlike dual immunotherapy, sunitinib does not expose patients with a favorable prognosis to undue risk of adverse events, while leaving more options for subsequent lines of therapy, and it's also often more cost-effective. The presented clinical observation is an example of successful monotherapy with sunitinib in a previously untreated mRCC patient with a favorable prognosis. This case is of particular interest due to the lesion of a single kidney and the patient's polymorbidity. Effective targeted therapy in the postoperative period had a positive effect on the quality and life expectancy.

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The authors declare that there are no conflicts of interest present.