Cleveland Clinic Taussig Cancer Institute, Ohio State University James Cancer Institute, Columbus, USA.
BJU Int. 2011 Nov;108(10):1546-54. doi: 10.1111/j.1464-410X.2011.10464.x. Epub 2011 Aug 24.
Advanced adrenal carcinoma remains a significant therapeutic challenge, with conventional approaches to systemic therapy having failed to achieve sustained objective remissions or major survival benefit in most instances. Several systemic therapies, including mitotane, suramin and gossypol, as well as cytotoxic agents, such as cisplatin and etoposide, have produced responses of ≈15-30%, with median survival figures of ≈6-15 months, depending on case selection bias, with only <10% 5-year survival rates. Recent preclinical and pathological studies have indicated a range of potential targets for drugs, including WNT/beta-catenin, epidermal growth factor receptor, RAF and k-RAS; similar applications in melanoma and renal carcinoma have achieved significant gains, and these targets are worthy of further, structured investigation. Advanced adrenal carcinoma constitutes an orphan disease, with a high mortality rate, and merits investment in clinical trials.
晚期肾上腺皮质癌仍然是一个重大的治疗挑战，在大多数情况下，传统的全身治疗方法未能实现持续的客观缓解或显著的生存获益。几种全身治疗方法，包括米托坦、苏拉明和棉酚，以及细胞毒性药物，如顺铂和依托泊苷，产生了约 15-30%的反应率，中位生存时间约为 6-15 个月，这取决于病例选择偏倚，只有 <10%的 5 年生存率。最近的临床前和病理学研究表明，针对包括 WNT/β-catenin、表皮生长因子受体、RAF 和 k-RAS 在内的一系列潜在药物靶点，类似的在黑色素瘤和肾细胞癌中的应用取得了显著的进展，这些靶点值得进一步的、有组织的研究。晚期肾上腺皮质癌是一种孤儿病，死亡率高，值得投资临床试验。
