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               ·152 ·                            南 京    医 科 大 学 学         报                        2021年1月


              dogenous RNA,ceRNA)机制促进肾细胞癌的增殖、                   [7] RINI B I,POWLES T,ATKINS M B,et al. Atezolizumab
              侵袭和转移。但是关于circRNA在肾细胞癌对舒尼                              plus bevacizumab versus sunitinib in patients with previ⁃
              替尼耐药机制中的作用目前几无文献报道。这也                                  ously untreated metastatic renal cell carcinoma(IMmo⁃
              许是一个有价值的研究方向。                                          tion151):a multicentre,open⁃label,phase 3,randomised
                                                                     controlled trial[J]. Lancet,2019,393(1189):2404-2415
              4  总结与展望                                          [8] CHOUEIRI T K,HESSEL C,HALABI S,et al. Cabozan⁃
                                                                     tinib versus sunitinib as initial therapy for metastatic re⁃
                  上述lncRNA及miRNA功能的研究显示,作为舒
                                                                     nal cell carcinoma of intermediate or poor risk(Alliance
              尼替尼作用主要靶点的VEGFR和PDGFR被抑制后,                             A031203 CABOSUN randomised trial):progression⁃free
              其他促进肿瘤进展的通路和功能被激活,从而引发肿                                survival by Independent review and overall survival up⁃
              瘤耐药,这可以看作是舒尼替尼对肾细胞癌的一种选                                date[J]. Eur J Cancer,2018,94:115-125
              择作用。而在这一过程中,非编码RNA受到其他通                           [9] MOTZER R J,PENKOV K,HAANEN J,et al. Avelumab
              路调节,lncRNA自身启动子序列甲基化也可以影响                              plus axitinib versus sunitinib for advanced renal⁃cell car⁃
              其表达。这似乎说明非编码RNA自身并不是整个耐                                cinoma[J]. N Engl J Med,2019,380(12):1103-1115
                                                                [10] MOTZER R J,RINI B,MCDERMOTT D F,et al. Niv⁃
              药过程的始动环节。circRNA在肾细胞癌对舒尼替
                                                                     olumab plus ipilimumab versus sunitinib in first ⁃ line
              尼耐药机制中的作用目前研究较少,值得挖掘。
                                                                     treatment for advanced renal cell carcinoma:extended fol⁃
                  尽管非编码 RNA 的表达水平有望成为肾细胞                             low⁃up of efficacy and safety results from a randomised,
              癌对舒尼替尼敏感性的预测指标和耐药产生后的                                  controlled,phase 3 trial[J]. Lancet Oncol,2019,20(10):
              新治疗靶点,我们仍然需要更多研究进一步发现非                                 1370-1385
              编码 RNA 在肾细胞癌对舒尼替尼反应性中发挥的                          [11] RINI B,PLIMACK E R,STUS V,et al. Pembrolizumab
              作用,以及在这些非编码RNA上游是否存在更初始                                plus axitinib versus sunitinib for advanced renal⁃cell car⁃
              的调控机制;并且确定切实可行的利用非编码RNA                                cinoma[J]. N Engl J Med,2019,380(12):1116-1127
              对患者预后进行预测和对耐药患者进行治疗的方法。                           [12] 刘  平,杨韬樾,常      磊,等. 酪氨酸激酶抑制剂联合局
                                                                     部病灶处理治疗转移性肾癌[J]. 南京医科大学学报
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