Révision de l’index thérapeutique des thérapies ciblées dans le cancer du rein : le mieux peut-il être l’ennemi du bien ? La toxicité peut-elle prédire l’efficacité ?

摘要: Since 2006, new treatments as targeted therapies (anti angiogenic and mTOR inhibitors) are prescribed in renal cell cancer. Toxicity of these is well known by clinicians. Occurrence side effects has been associated with anti tumoral efficacy. High blood pressure, hypothyroidie hand foot syndrome were reported to be predictive response. Fatigue hyponatremia still largely discussed. Moreover, non infectious pneumonia, which frequently occurs inhibitors, clinical benefit. The main objective treatment advanced kidney cancer, specially obtaining benefit (stabilization response) a chronic evolution the disease. This prolong exposure drugs, according their toxicity profile, often contributes dose reduction, moreover interruption treatment, potentially loss control Thus, adverse effects, described hereby, may considered « positive events », predicting efficacy, thus looked for… sequential approach, emphasizes need defining optimal sequence. because lack molecular biomarkers date, this predictives secondary help for selecting therapeutic strategy.