Department of Medicine, and Montefiore-Einstein Center for Cancer Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Semin Oncol. 2010 Dec;37(6):691-5. doi: 10.1053/j.seminoncol.2010.10.020.
Current treatment of endocrine cancers relies primarily on surgical resection, which is generally effective only for localized disease. Radioactive iodine treatment is an important modality for those thyroid cancers that maintain the ability to take up iodine. For endocrine cancers that are no longer localized, current modes of therapy, including various combinations of chemotherapy and radiation, are inadequate, posing a major challenge to ongoing research to develop more effective methods for diagnosis and treatment. In this article, we offer some predictions of future trends in the diagnosis and treatment of endocrine cancers. Following a general introduction, we focus on thyroid cancer as a paradigm for what we may expect in future developments, and then add selected comments relevant to parathyroid, adrenocortical, and gastrointestinal and pancreatic neuroendocrine tumors. Rapid, inexpensive whole genome sequencing of both germline and tumor DNA, novel molecular and functional imaging, as well as new biomarkers are expected to enable more precise diagnosis, targeted therapy, and possibly prevention. Translating the coming wave of data on the molecular pathogenesis of endocrine cancers into practical diagnostic and treatment modalities will require new forms of collaboration between investigators, clinicians, and industry.
目前，内分泌癌的治疗主要依赖于手术切除，而手术切除通常仅对局限性疾病有效。放射性碘治疗对于那些仍能摄取碘的甲状腺癌是一种重要的治疗方式。对于已经扩散的内分泌癌，目前的治疗方法，包括化疗和放疗的各种组合，都不够有效，这对正在进行的研究开发更有效的诊断和治疗方法构成了重大挑战。在本文中，我们对内分泌癌的诊断和治疗的未来趋势提出了一些预测。在一般性介绍之后，我们重点关注甲状腺癌，将其作为未来发展的范例，然后添加与甲状旁腺、肾上腺皮质、胃肠道和胰腺神经内分泌肿瘤相关的选定评论。快速、廉价的种系和肿瘤 DNA 全基因组测序、新型分子和功能成像以及新的生物标志物有望实现更精确的诊断、靶向治疗，甚至可能预防。将内分泌癌分子发病机制方面的大量数据转化为实用的诊断和治疗方法，需要研究人员、临床医生和行业之间开展新型合作。
