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系统治疗先进的甲状腺髓癌的系统疗法
Marco Ruiz Santillan1, Ramona Dadu1, Robert F Gagel1
1Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
概括
甲状腺髓癌 (MTC) 的治疗方法正在发展. 虽然多酶抑制剂显示出一些疗效,新的RET抑制剂提供更好的耐受性,但耐药性仍然是先进的MTC的挑战.
科学领域:
- 在瘤学瘤学.
- 分子生物学分子生物学
- 药理学 药理学是指药理学的学科.
背景情况:
- 骨髓甲状腺癌 (MTC) 是一种罕见的甲状腺癌,通常是惰的,但可以是攻击性的和转移性的.
- 目前对高级MTC的治疗包括多激酶抑制剂 (MKIs) 和选择性RET抑制剂.
- RET突变是MTC的关键驱动因素,RAS突变也与此有关.
研究的目的:
- 审查先进的MTC目前的全身疗法.
- 讨论现有治疗方法的局限性和毒性.
- 突出正在进行的研究,以更有效的MTC疗法.
主要方法:
- 关于MTC系统疗法的当前文献的综述.
- 对MKI和RET抑制剂的疗效和毒性概况的分析.
- 在MTC中讨论药物耐药性的机制.
主要成果:
- 像卡博桑提尼布和万德坦尼布这样的MKI具有抗血管性作用和轻微的抗RET活性,但具有显著的毒性.
- 选择性RET抑制剂 (selpercatinib,pralsetinib) 在RET改变的MTC中显示出显著的疗效和更好的耐受性.
- 由于获得的突变导致的耐药性限制了对当前疗法的持续反应.
结论:
- 虽然较新的RET抑制剂代表了进步,但在先进的MTC中,耐久性反应受到抵抗的挑战.
- 开发新型和更有效的治疗方法来治疗渐进的MTC是一个至关重要的未满足的需求.
- 对克服耐药性的进一步研究对于改善MTC患者的治疗结果至关重要.
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