成年质母细胞瘤精度瘤学的现状
Johannes Weller1, Anna-Laura Potthoff2, Thomas Zeyen1
1Department of Neurooncology, Center for Neurology, University Hospital Bonn, Germany.
Molecular oncology
|June 20, 2024
概括
精确瘤在质母细胞瘤 (GBM) 显示有限的成功,有针对性的治疗只有利于患者的一个子集. 未来的战略需要以途径为重点的方法和改善向中枢神经系统 (CNS) 的药物输送.
科学领域:
- 神经瘤学神经瘤学
- 分子瘤学分子瘤学
- 翻译医学是一种翻译医学.
背景情况:
- 质母细胞瘤 (GBM) 是一种具有不良预后的侵袭性脑瘤.
- 精密瘤学旨在通过分子分析来个性化癌症治疗.
- 目前针对GBM的向疗法已显示出有限的疗效.
研究的目的:
- 审查质母细胞瘤精度瘤学的现状.
- 确定针对性治疗在GBM中的成功和挑战.
- 建议未来的方向,以推进GBM的精确瘤学.
主要方法:
- 对GBM精密瘤学现有文献的审查.
- 对GBM中向治疗的临床试验数据的分析.
- 评估分子变化及其治疗影响.
主要成果:
- 没有事先目标验证的向治疗在很大程度上失败了.
- BRAF V600E 突变的 GBM 显示受益于 BRAF/MEK 抑制.
- 由于生物挑战,EGFR的向一直没有成功.
- 系统选的结果是可采取行动的目标率很低 (<10%).
- 在三分之一的患者中观察到有效性,主要是使用BRAF,VEGFR和mTOR抑制剂.
结论:
- 在GBM中推进精确瘤学需要从单个改变转向基于途径的策略.
- 需要新的临床试验设计,以快速,适应性药物评估.
- 专注于具有充分的中枢神经系统 (CNS) 生物可用性的药物至关重要.
- 扩大目标发现范围,包括瘤微环境,细胞网络和免疫相互作用是必不可少的.
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