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[阴茎癌靶向治疗的价值]

[Value of targeted therapy for penile cancer].

作者信息

Heidenreich A, Thüer D, Pfister D

机构信息

Klinik und Poliklinik für Urologie, Bereich Urologische Onkologie, Uniklinik, Kerpener Strasse 62, 50937 Köln, Deutschland.

出版信息

Urologe A. 2008 Oct;47(10):1320-7. doi: 10.1007/s00120-008-1749-7.

DOI:10.1007/s00120-008-1749-7
PMID:18587553
Abstract

With an incidence of 0.1-0.9/100,000 men/year, penile cancer is a rare cancer of the urogenital tract in Western Europe. At the time of initial diagnosis up to 45% of the patients already demonstrate metastatic disease and need some type of systemic treatment. Objective remission rates and 3-year survival rates of 30 and < 10%, respectively, are depressingly low. Identification of molecular targets for the introduction of molecular triggered therapies such as monoclonal antibodies and tyrosine kinase inhibitors might improve the poor prognosis and could replace non-targeted systemic chemotherapies with a less toxic targeted therapy.However, a MEDLINE search does not identify any current clinical trial with regard to targeted therapeutic approaches in penile cancer. Based on a systematic review of the molecular events involved in the metastatic process of penile cancer, therapeutic approaches with bevacizumab or COX-2 inhibitors appear to have the greatest potential to improve the prognosis. In order to perform a prospective clinical phase 2/3 trial in such a low frequency cancer, international cooperative structures have to be established.

摘要

阴茎癌在西欧是一种罕见的泌尿生殖道癌症,年发病率为每10万名男性0.1 - 0.9例。在初次诊断时,高达45%的患者已出现转移性疾病,需要某种类型的全身治疗。客观缓解率和3年生存率分别为30%和不到10%,低得令人沮丧。确定分子靶点以引入分子触发疗法,如单克隆抗体和酪氨酸激酶抑制剂,可能会改善这种不良预后,并能用毒性较小的靶向疗法取代非靶向全身化疗。然而,MEDLINE搜索未发现任何关于阴茎癌靶向治疗方法的当前临床试验。基于对阴茎癌转移过程中涉及的分子事件的系统综述,贝伐单抗或COX - 2抑制剂的治疗方法似乎具有改善预后的最大潜力。为了在这种低频癌症中进行前瞻性临床2/3期试验,必须建立国际合作结构。

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引用本文的文献

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Penile cancer: epidemiology and treatment.阴茎癌:流行病学和治疗。
Curr Oncol Rep. 2011 Jun;13(3):231-9. doi: 10.1007/s11912-011-0163-2.
2
[The current state of the art of chemotherapy of penile cancer: results of a nationwide survey of German clinics].[阴茎癌化疗的当前技术水平:德国诊所全国性调查结果]
Urologe A. 2009 Dec;48(12):1495-8. doi: 10.1007/s00120-009-2108-z.
3
[Characterization of the EGF receptor status in penile cancer : retrospective analysis of the course of the disease in 45 patients].阴茎癌中表皮生长因子受体状态的特征:45例患者疾病进程的回顾性分析

本文引用的文献

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Randomized, double-blind, placebo-controlled phase II trial of maintenance sunitinib versus placebo after chemotherapy for patients with advanced urothelial carcinoma: scientific rationale and study design.晚期尿路上皮癌患者化疗后舒尼替尼维持治疗对比安慰剂的随机、双盲、安慰剂对照II期试验:科学依据与研究设计
Clin Genitourin Cancer. 2007 Dec;5(7):460-3. doi: 10.3816/CGC.2007.n.037.
2
Bevacizumab plus interferon alfa-2a for treatment of metastatic renal cell carcinoma: a randomised, double-blind phase III trial.贝伐单抗联合干扰素α-2a治疗转移性肾细胞癌:一项随机、双盲III期试验。
Lancet. 2007 Dec 22;370(9605):2103-11. doi: 10.1016/S0140-6736(07)61904-7.
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Urologe A. 2009 Dec;48(12):1483-9. doi: 10.1007/s00120-009-2101-6.
Human papillomavirus-associated increase in p16INK4A expression in penile lichen sclerosus and squamous cell carcinoma.
人乳头瘤病毒相关的阴茎硬化性苔藓和鳞状细胞癌中p16INK4A表达增加。
Br J Dermatol. 2008 Feb;158(2):261-5. doi: 10.1111/j.1365-2133.2007.08305.x. Epub 2007 Nov 28.
4
Human papillomavirus-16 is the predominant type etiologically involved in penile squamous cell carcinoma.人乳头瘤病毒16型是阴茎鳞状细胞癌主要的病因相关类型。
J Clin Oncol. 2007 Oct 10;25(29):4550-6. doi: 10.1200/JCO.2007.12.3182.
5
A 10-year retrospective audit of penile cancer management in the UK.英国阴茎癌治疗的10年回顾性审计
BJU Int. 2007 Dec;100(6):1277-81. doi: 10.1111/j.1464-410X.2007.07168.x. Epub 2007 Sep 10.
6
[Neoadjuvant and adjuvant chemotherapy in patients with advanced penile cancer].[晚期阴茎癌患者的新辅助化疗和辅助化疗]
Urologe A. 2007 Oct;46(10):1395-6, 1398-9. doi: 10.1007/s00120-007-1545-9.
7
Human papillomavirus genotypes and HPV16 variants in penile carcinoma.阴茎癌中的人乳头瘤病毒基因型及HPV16变体
Int J Cancer. 2008 Jan 1;122(1):132-7. doi: 10.1002/ijc.23062.
8
Targeting EGFR and HER-2 with cetuximab- and trastuzumab-mediated immunotherapy in oesophageal squamous cell carcinoma.在食管鳞状细胞癌中,使用西妥昔单抗和曲妥珠单抗介导的免疫疗法靶向表皮生长因子受体(EGFR)和人表皮生长因子受体2(HER-2)
Br J Cancer. 2007 Aug 20;97(4):494-501. doi: 10.1038/sj.bjc.6603885. Epub 2007 Jul 10.
9
Temsirolimus, interferon alfa, or both for advanced renal-cell carcinoma.替西罗莫司、干扰素α或两者联合用于晚期肾细胞癌。
N Engl J Med. 2007 May 31;356(22):2271-81. doi: 10.1056/NEJMoa066838.
10
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BJU Int. 2007 Jul;100(1):204-8. doi: 10.1111/j.1464-410X.2007.06908.x. Epub 2007 Apr 13.