本文简要介绍 2024年肾癌诊治方面的重要研究进展。除有关免疫/靶向治疗的系列临床Ⅲ期研究的长期随访结果被陆续报道外，针对肾透明细胞癌靶向放射性核素药物（如CAIX和CD70等） 取得初步进展，可能为其诊断和治疗提供新的策略。立体定向放射治疗可能成为不适合/拒绝手术患者有效的替代性局部治疗手段。围手术期系统性治疗，特别是针对局部进展期肾癌伴有静脉瘤栓的患者，多个前瞻性研究取得了较好疗效，为肾癌新辅助治疗积累了参考数据。有关局部高危肾癌术后辅助治疗的Ⅲ期研究，帕博利珠单抗取得了长期的总生存期获益，而纳武利尤单抗的结果没有显示出患者预后的改善，因此还需要后续进一步探索。转移性肾癌一线治疗，国内开展的ETER-100研究为靶向联合PD-L1单抗治疗提供了有力支持。数个研究显示一线靶免联合治疗失败后继续免疫联合靶向药物不能获益，可能更适合选择靶向单药治疗，新型靶向药物HIF-2α抑制剂成为未来治疗的希望。多组学测序及生物标志物的探索，有助于更加个体化和精准化治疗策略的选择，从而提高患者治疗效果，改善远期生存。

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胡旭,李响. 2024年肾癌诊治进展[J].泌尿外科杂志(电子版),2025,17(1):31-36.DOI:10.20020/j.CNKI.1674-7410.2025.01.05

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肾细胞癌（renal cell carcinoma，RCC）是泌尿系统常见的恶性肿瘤之一。根据国际癌症研究机构发布的 GLOBOCAN 2022 最新统计，2022年全球新增RCC病例约43万例，占所有癌症新发病例的2.2%^[1]。随着相关临床试验的开展，免疫联合靶向治疗已显著改善晚期肾癌患者预后。与此同时，放射性核素药物，新型免疫检查点抑制剂和靶向药物也在肾癌中相继开展研究，为肾癌患者的诊治提供新的手段。由于多组学技术的推广，对于肾癌的分子特征和生物学行为的认识也更加深入，有助于指导临床医师对患者进行分层管理以及治疗策略的选择。本文主要对2024年肾癌上述相关领域在国际专业顶尖杂志和美国临床肿瘤学会（American Society of Clinical Oncology，ASCO）、欧洲肿瘤内科学会（European Society for Medical Oncology， ESMO）等会议发表报告的重要研究进展予以简要介绍。

1 肾癌放射性核素药物诊疗新策略

2 围手术期治疗进展

2.1 局部治疗

2.2 新辅助治疗

2.3 辅助治疗

3 晚期肾癌的系统化治疗

3.1 一线治疗

3.2 后线治疗

4 组学特征及生物标志物探索

总的来说，2024年肾癌在新辅助治疗、一线治疗、后线治疗、组学特征等方面均取得了较多的进展，并且越来越多的国内肾癌专家参与其中，为肾癌领域发展做出了贡献。未来也期待更多更高质量的研究成果，进一步推动肾癌领域的发展。

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