Vulvar 癌症生物学和管理方面的进展
Rania Chehade1, Katarzyna J Jerzak1, Farideh Tavanger2
1Division of Medical Oncology and Hematology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
概括
根据人类乳头瘤病毒 (HPV) 和p53状态分类的平状细胞癌 (VSCC) 的分子分类为新的治疗途径. 精准医学策略和国际合作对于推进VSCC护理至关重要.
科学领域:
- 妇科瘤学 妇科瘤学
- 分子病理学分子病理学
- 翻译癌症研究 翻译癌症研究
背景情况:
- Vulvar状细胞癌 (VSCC) 是一种罕见的恶性瘤,发病率不断增加.
- 目前对VSCC的治疗方法在很大程度上是统一的,尽管分子上有不同的亚型.
- 基于人类乳头瘤病毒 (HPV) 和瘤蛋白53 (p53) 状态的分子分类确定了临床上相关的VSCC亚型.
研究的目的:
- 审查VSCC的分子分类.
- 概述目前高级VSCC的治疗环境.
- 突出基于分子分层的向治疗的潜力.
主要方法:
- 综合文献综述,重点关注先进的VSCC治疗.
- 分析HPV和p53分层对治疗策略的影响.
- 探索潜在的向疗法和临床试验设计.
主要成果:
- HPV和p53状态可以指导局部区域VSCC治疗的 (降级).
- 免疫疗法的作用,尤其是在疾病进展的早期,需要进一步研究.
- 向治疗 (VEGF,EGFR,细胞循环,DDR抑制剂) 是有前途的,特别是在HPV阴性VSCC中.
- 针对PI3K/mTOR途径的向对HPV阳性和HPV-/p53野生型VSCC具有吸引力.
- 抗体药物合物和篮子试验是合理的;需要改进的临床前模型.
结论:
- 与其他罕见癌症相比, Vulvar 癌症在精准医学采用方面落后.
- 开发基于分子的临床前模型对于合理的临床试验设计至关重要.
- 国际合作对于推进VSCC治疗和改善患者治疗结果至关重要.
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