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難治性卵巢癌的新治療策略：透明細(xì)胞癌和粘液癌

發(fā)表日期：2022-02-16

難治性卵巢癌的新治療策略：透明細(xì)胞癌和粘液癌

Novel Therapeutic Strategies for Refractory Ovarian Cancers: Clear Cell and Mucinous Carcinomas

Ovarian clear cell and mucinous carcinomas are less sensitive to chemotherapy. This can be explained by carcinogenic mechanisms and molecular biological features. Although chemotherapy with cytotoxic anticancer drugs has been evaluated by clinical studies, none have achieved better treatment outcomes than paclitaxel + carboplatin therapy. In recent years, attention has been focused on treatment with molecular target drugs and immune checkpoint inhibitors that target newly identified biomarkers, and many clinical studies on such treatments have been planned.

卵巢透明細(xì)胞癌和粘液癌對(duì)化療不太敏感。這可以通過(guò)致癌機(jī)制和分子生物學(xué)特征來(lái)解釋。盡管已通過(guò)臨床研究評(píng)估了使用細(xì)胞毒性抗癌藥物進(jìn)行化療，但沒(méi)有一個(gè)比紫杉醇+卡鉑治療取得更好的治療效果。近年來(lái)，人們將注意力集中在針對(duì)新發(fā)現(xiàn)的生物標(biāo)志物的分子靶向藥物和免疫檢查點(diǎn)抑制劑的治療上，并且已經(jīng)計(jì)劃了許多關(guān)于此類治療的臨床研究。

5L高效搖瓶

Ovarian cancer has the worst prognosis among gynecological cancers. In particular, clear cell and mucinous carcinomas are less sensitive to chemotherapy. The establishment of new therapies is necessary to improve the treatment outcomes for these carcinomas. In previous clinical studies, chemotherapy with cytotoxic anticancer drugs has failed to demonstrate better treatment outcomes than paclitaxel + carboplatin therapy. In recent years, attention has been focused on treatment with molecular target drugs and immune checkpoint inhibitors that target newly identified biomarkers. The issues that need to be addressed include the most appropriate combination of therapies, identifying patients who may benefit from each therapy, and how results should be incorporated into the standard of care for ovarian clear cell and mucinous carcinomas. In this article, we have reviewed the most promising therapies for ovarian clear cell and mucinous carcinomas, which are regarded as intractable, with an emphasis on therapies currently being investigated in clinical studies.

在婦科癌癥中，卵巢癌的預(yù)后最差。特別是，透明細(xì)胞癌和粘液癌對(duì)化療不太敏感。新療法的建立對(duì)于改善這些癌癥的治療結(jié)果是必要的。在之前的臨床研究中，細(xì)胞毒性抗癌藥物化療未能證明比紫杉醇+卡鉑治療更好的治療效果。近年來(lái)，注意力集中在針對(duì)新發(fā)現(xiàn)的生物標(biāo)志物的分子靶向藥物和免疫檢查點(diǎn)抑制劑的治療上。需要解決的問(wèn)題包括最合適的治療組合，確定可能從每種治療中受益的患者，以及如何將結(jié)果納入卵巢透明細(xì)胞癌和粘液癌的護(hù)理標(biāo)準(zhǔn)。

三角細(xì)胞搖瓶

Ovarian cancer is diverse at the molecular level, and clear cell and mucinous carcinomas exhibit low sensitivity to chemotherapy. Although chemotherapy regimens for ovarian clear cell and mucinous carcinomas have been evaluated by numerous clinical studies, they have failed to exhibit treatment outcomes superior to those of TC therapy. The identification of biomarkers and development of therapeutic drugs specific to each type of ovarian cancer are anticipated. For ovarian clear cell carcinoma, in which the PI3K/AKT/mTOR pathway and the MDM2 gene are prognostic factors, AKT and MDM2 inhibitors may prove to be promising therapeutic drugs in the future. The biomakers for ovarian mucinous carcinoma, including the KRAS and HER2-neu genes, MEK, and PI3K, and molecular target drugs such as trastuzumab, lapatinib, and cetuximab have been gaining attention. We hope that molecular target drugs and immune checkpoint inhibitors targeting these genomic alterations will be developed and clinically applied in the future.

細(xì)胞工廠

卵巢癌在分子水平上是多種多樣的，透明細(xì)胞癌和粘液癌對(duì)化療的敏感性較低。盡管卵巢透明細(xì)胞癌和粘液性癌的化療方案已通過(guò)大量臨床研究進(jìn)行評(píng)估，但它們未能表現(xiàn)出優(yōu)于 TC 治療的治療效果。預(yù)計(jì)針對(duì)每種卵巢癌的生物標(biāo)志物的鑒定和治療藥物的開(kāi)發(fā)。對(duì)于卵巢透明細(xì)胞癌，其中 PI3K/AKT/mTOR 通路和MDM2基因是預(yù)后因素，AKT 和MDM2抑制劑可能被證明是未來(lái)有希望的治療藥物。卵巢粘液癌的生物標(biāo)志物，包括KRAS和HER2-neu基因、MEK、PI3K，以及曲妥珠單抗、拉帕替尼、西妥昔單抗等分子靶向藥物備受關(guān)注。我們希望未來(lái)能夠開(kāi)發(fā)出針對(duì)這些基因組改變的分子靶向藥物和免疫檢查點(diǎn)抑制劑并應(yīng)用于臨床。