卵巢癌治疗。

IF 7.8 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL
Diana Miao, Ursula A Matulonis, Rebecca L Porter
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引用次数: 0

摘要

基础和转化研究的重大进展提高了我们对上皮性卵巢癌(EOC)不同组织学亚群的分子改变和生物脆弱性的理解。这导致临床试验将基于分子方面的新药物纳入新诊断和复发疾病的治疗范式。在过去的十年中,美国和欧洲已经批准了几种用于EOC治疗的监管机构,包括抗血管生成剂贝伐单抗,各种治疗环境中的聚(adp -核糖)聚合酶抑制剂,以及抗体-药物偶联物(ADC) mirvetuximab soravtansine。除了罕见的微卫星不稳定性(MSI)高的卵巢癌外,免疫检查点抑制剂作为单一药物在卵巢癌中没有显示出实质性的活性。目前的研究重点是新的治疗模式,如adc、基因特异性治疗和其他新的免疫治疗,如双特异性抗体、放射配体治疗、细胞治疗和疫苗。此外,联合治疗的重点是将传统化疗、靶向治疗、免疫肿瘤药物和/或新型药物结合起来,以改善新诊断和复发性EOC患者的预后。本综述将重点关注高级别浆液性卵巢癌的治疗,这是最常见的EOC类型,约占病例的75%。本文将简要讨论具有不同分子和临床特征的罕见组织学亚型(包括透明细胞型、黏液型、子宫内膜样和低级别浆液型)的治疗进展。非eocs,包括生殖细胞和性索间质瘤及其治疗,已经在其他地方进行了综述[见Ray-Coquard等人(2019)]。中华医学杂志,331(2):416- 428。doi: 10.1056 / NEJMoa1911361]。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ovarian Cancer Therapy.

Significant advances in basic and translational research have improved our understanding of the molecular alterations and biological vulnerabilities of the different histologic subsets of epithelial ovarian cancer (EOC). This has led to clinical trials that have incorporated novel agents based on molecular aspects into the treatment paradigm for both newly diagnosed and recurrent disease. The past decade has witnessed several regulatory approvals in the United States and Europe for the treatment of EOC, including the antiangiogenic agent, bevacizumab, poly(ADP-ribose) polymerase inhibitors in various therapeutic settings, and the antibody-drug conjugate (ADC), mirvetuximab soravtansine. Immune checkpoint inhibitors do not demonstrate substantial activity as single agents in ovarian cancer, except for the rare entity of microsatellite instability (MSI) high ovarian cancer. Current research is focused on new treatment paradigms such as ADCs, genetically specific therapies, and other novel immunotherapies such as bispecific antibodies, radioligand therapies, cellular therapies, and vaccines. In addition, combination efforts are focused on incorporating conventional chemotherapy, targeted therapies, immune-oncology drugs, and/or novel agents to improve outcomes for patients with newly diagnosed as well as recurrent EOC. This review will focus on the management of high-grade serous ovarian cancer, the most common type of EOC, accounting for ∼75% of cases. Recent advances in the management of rarer histologic subtypes with distinct molecular and clinical characteristics, including clear cell, mucinous, endometrioid, and low-grade serous, will be briefly discussed. Non-EOCs, including germ cell and sex cord stromal tumors and their treatment, have been reviewed elsewhere [see Ray-Coquard et al. (2019). N Engl J Med 381: 2416-2428. doi:10.1056/NEJMoa1911361].

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来源期刊
Cold Spring Harbor perspectives in medicine
Cold Spring Harbor perspectives in medicine MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
14.30
自引率
1.90%
发文量
44
审稿时长
4-8 weeks
期刊介绍: Cold Spring Harbor Perspectives in Medicine is a monthly online publication comprising reviews on different aspects of a variety of diseases, covering everything from the molecular and cellular bases of disease to translational medicine and new therapeutic strategies. Cold Spring Harbor Perspectives in Medicine is thus unmatched in its depth of coverage and represents an essential source where readers can find informed surveys and critical discussion of advances in molecular medicine.
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