分子分类改善了患有骨髓母细胞瘤的婴儿和幼儿的治疗选择
Aditi Bagchi1, Sandeep K Dhanda1, Paige Dunphy1
11Division of Neuro-Oncology, Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.
Journal of the National Comprehensive Cancer Network : JNCCN
|August 29, 2023
概括
由于辐射损伤,治疗婴儿脑髓母细胞瘤具有挑战性. 像Sonic Hedgehog (SHH) 和Group 3 (G3) 这样的分子子组现在指导风险分层的,少有毒的化疗方案.
科学领域:
- 儿科瘤学 儿科瘤学
- 神经瘤学神经瘤学
- 分子诊断学 分子诊断
背景情况:
- 脊辐射 (CSI) 对患有脑髓母细胞瘤的幼儿有害,限制了治疗选择.
- 之前修改CSI的尝试取得了有限的成功,导致高复发率的仅化学疗法方案.
- 分子进步揭示了婴儿脑髓母细胞瘤中生物驱动的治疗反应.
研究的目的:
- 审查婴儿和幼儿中脑髓母细胞瘤的当前治疗策略.
- 讨论分子分组对治疗结果的影响.
- 提出基于分子风险分层的未来管理框架.
主要方法:
- 对婴儿脑髓母细胞瘤现有临床试验和治疗方法的审查.
- 分析分子子组 (Sonic Hedgehog和组3) 以及它们对治疗的反应.
- 分子形状与治疗结果和毒性的相关性.
主要成果:
- 婴儿的脑细胞瘤被分为Sonic Hedgehog (SHH) 和第三组 (G3) 的分子组.
- SHH髓母细胞瘤对化疗敏感,SHH-2在不那么密集的治疗中显示出更好的结果.
- 第三组髓母细胞瘤仅使用化疗就有很高的复发率,因此需要采用替代策略.
结论:
- 分子分组允许在婴儿脑髓母细胞瘤中进行准确的风险分层.
- 根据分子形状量身定制治疗可以优化治愈率并最大限度地减少毒性.
- 未来的管理应整合分子诊断,以个性化治疗幼儿脑髓母细胞瘤.
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