间皮瘤的当代管理。

IF 2.3 Q2 RESPIRATORY SYSTEM
Breathe Pub Date : 2024-07-16 eCollection Date: 2024-06-01 DOI:10.1183/20734735.0175-2023
Mark D J Neilly, Jennifer Pearson, Akari Win Thu, Carolyn MacRae, Kevin G Blyth
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引用次数: 0

摘要

胸膜间皮瘤(PM)是一种侵袭性石棉相关胸部恶性肿瘤,中位生存期为 12-18 个月。由于许多国家继续使用石棉,全球发病率正在上升。在许多国家,尽管禁止使用石棉,但由于非职业性环境接触导致的发病率也在上升。多年来,铂--培美曲塞化疗一直是唯一获得许可的疗法,但最近一线联合免疫检查点阻断疗法的疗效有所改善,这两种疗法主要在晚期队列中进行了测试。在二线治疗中,单药 nivolumab 已被证明可以延长生存期,目前在一些地区已可常规使用,而二线化疗的作用尚未得到证实,对于复发的疾病,应最大限度地利用临床试验的机会。几十年来,许多专家中心一直为 "技术上可切除 "的疾病提供手术治疗,但最近III期MARS2试验的结果对这种方法提出了挑战。对于早期原发性骨髓瘤,目前仍没有经过充分验证的治疗标准。原发性骨髓瘤的临床试验情况复杂且日益多样化,因此,进一步发展原发性骨髓瘤多学科专科团队是所有国家的当务之急。据观察,采用这种服务模式的中心的治疗效果不断改善,这强调了高质量诊断以及公平获得治疗和试验机会的重要性。目前正在对针对一系列畸变的新型疗法进行评估;然而,需要更好地了解分子驱动因素及其相关的脆弱性,以确定治疗目标并进行优先排序。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Contemporary management of mesothelioma.

Pleural mesothelioma (PM) is an aggressive asbestos-associated thoracic malignancy with a median survival of 12-18 months. Due to continued asbestos use in many nations, global incidence is rising. Causes due to non-occupational, environmental exposure are also rising in many countries despite utilisation bans. For many years, platinum--pemetrexed chemotherapy was the solitary licensed therapy, but first-line combination immune checkpoint blockade has recently demonstrated improved outcomes, with both regimes tested in predominantly late-stage cohorts. In the second-line setting, single-agent nivolumab has been shown to extend survival and is now available for routine use in some regions, while second-line chemotherapy has no proven role and opportunities for clinical trials should be maximised in relapsed disease. Surgery for "technically resectable" disease has been offered for decades in many expert centres, but the recent results from the phase III MARS2 trial have challenged this approach. There remains no robustly proven standard of care for early-stage PM. The clinical trial landscape for PM is complex and increasingly diverse, making further development of specialist PM multidisciplinary teams an important priority in all countries. The observation of improving outcomes in centres that have adopted this service model emphasises the importance of high-quality diagnostics and equitable access to therapies and trials. Novel therapies targeting a range of aberrations are being evaluated; however, a better understanding of the molecular drivers and their associated vulnerabilities is required to identify and prioritise treatment targets.

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来源期刊
Breathe
Breathe RESPIRATORY SYSTEM-
CiteScore
2.90
自引率
5.00%
发文量
51
审稿时长
12 weeks
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