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侵袭性垂体瘤和癌症:除了temozolomide之外的医疗治疗

Dario DE Alcubierre^1,2, Anna L Carretti^1,3, François Ducray⁴

¹Department of Experimental Medicine, Sapienza University, Rome, Italy.

Minerva endocrinology

|January 19, 2024

概括

侵袭性垂体瘤,包括垂体癌,往往抵御标准治疗. 免疫检查点抑制剂和贝瓦西祖马布在特莫佐洛米德失败后显示出有前途的后续疗法,需要进一步的研究.

科学领域:

内分泌学在内分泌学.
在瘤学瘤学.
神经外科神经外科

背景情况:

侵袭性垂体瘤和垂体癌呈现出快速生长,侵入性和对标准治疗的抗性.
在标准治疗失败后,Temozolomide是推的第一线疗法,但反应率和持续时间是可变的.
在特莫索洛米德失败后,有效的二线或三线疗法的证据有限.

研究的目的:

审查当前的证据,新兴的治疗方法的攻击性垂体瘤和垂体癌症在temozolomide失败后.
评估新型治疗策略的疗效,安全性和潜在反应预测因素.
为未来的治疗方向和个性化方法的需求提供见解.

主要方法:

综合文献综述2023年4月之前发表的研究.
对免疫检查点抑制剂,贝瓦齐祖马布,类放射性核酸受体治疗,氨酸激酶抑制剂和mTOR抑制剂的证据分析.
包含一个未发表的下垂体癌进展和随后治疗的案例研究.

主要成果:

免疫检查点抑制剂和bevacizumab作为后temozolomide疗法表现出最有前途的疗效,特别是在下垂体癌症中免疫检查点抑制剂.
类放射性核酸受体治疗显示出一些疗效,而氨酸激酶抑制剂和mTOR抑制剂的疗效有限或没有被证明.
一个未公布的病例显示,在双重免疫疗法进展后,用隆慕斯和贝瓦齐祖马布治疗稳定了疾病.

结论:

免疫检查点抑制剂和贝瓦西祖马布代表了对侵袭性脑垂体瘤和对temozolomide耐火的脑垂体癌症的有前途的治疗选择.
进一步的研究对于验证这些发现和建立最佳治疗算法至关重要.
个性化,针对患者量身定制的方法对于管理这些罕见和积极的瘤至关重要.

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