Малый процент эффективности, путем иммунотерапии, в лечении метастазирующего рака почки (РП) привел к появлению таргетных препаратов. В их задачу входит ингибирование (подавление) метастаз. Фармакологические компании откликнулись на потребности медицины в противоопухолевых препаратах. И мир увидел множество готовых решений. Причем для лечения рака на разных стадиях:
- Тирозинкиназные (мультикиназные) ингибиторы.
- Ингибиторы mTOR.
- Моноклональные антитела.
Для каждого вида есть наиболее эффективные препараты. Тирозинкиназные используются с хорошим и умеренным прогнозом. Среди них – Сутент с действующим веществом Сунитиниб. Ингибиторы mTOR – это 1я линия терапии с плохим прогнозом. А моноклональные антитела – это профилактические средства, используемые, например, для недопустимости отторжения почки при трансплантации.
Аспекты применения Сутента в онкологической практике
Противоопухолевый препарат Сутент (Сунитиниб) ориентирован на лечение рака почек и опухолей в пищеварительном тракте. В исследованиях, Сунитиниб показал высокую эффективность в лечении рака толстой кишки, меланомы, немелкоклеточного рака легкого, почечноклеточного и плоскоклеточного рака. То есть, продемонстрировал высокую противоопухолевую активность в больших масштабах. Что стало поводом для дальнейших исследований, связанных, как с продуктивностью лечения, так и выявлением побочных эффектов.
До появления Сутента на мировом рынке считалось, что хирургическое вмешательство – это единственный и лучший способ лечения РП. С болевым синдромом боролись с помощью химиотерапии и принимали гормоны. Однако эффект, со временем, оказался нестойким, а ремиссии непродолжительными. С появлением таргетного препарата Сутент (Сунитиниб) ситуация изменилась. Таблетированный ингибитор тирозинкиназ, путем воздействия на все виды рецепторов PDGF и VEGF (VEGFRs, PDGFR–α, PDGFR–β, c–KIT и FLT–3) дал более эффективный результат.
Анализ общей выживаемости показал, что прием Сунитиниба значительно увеличивает период для людей на разных стадиях рака почек. Стабилизация заболевания зафиксирована у 70% пациентов. Однако в клинических исследования больных РП на 3-й стадии, проявились не гематологические побочные эффекты. В частности, диарея, тошнота, рвота, утомляемость. Поэтому, при выборе противоопухолевого препарата, важно учитывать все побочные эффекты, с которыми пациент может столкнуться на курсе лечения. Врач может назначить, например, другой мультикиназный ингибитор.
А еще, следует учитывать рекомендации всемирной организации здравоохранения. Ведь рак почек бывает наследственный и спорадический (не наследственный). Что кардинально меняет ситуацию, связанную с мутацией генов. Соответственно, перед лечением, в обязательном порядке надо проводить полное исследование. А лечащий врач должен разбираться в онкологии и назначить правильное лечение. На рынке достаточно эффективных противоопухолевых препаратов. И их список ежегодно пополняется.
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