Comprehensive Cancer Center Vienna, Department of Medicine I/Division of Oncology, Medical University of Vienna, Austria.
Gynecol Oncol. 2012 Aug;126(2):291-303. doi: 10.1016/j.ygyno.2012.04.007. Epub 2012 Apr 11.
Cervical cancer represents the third most common cause of female cancer mortality. Even with the best currently available treatment, a significant proportion of patients will experience recurrence and eventually die. Evidently, there is a clear need for the development of new agents with novel mechanisms of action in this disease. A number of biological agents modulating different signal transduction pathways are currently in clinical development, inhibiting angiogenesis, targeting epidermal growth factor receptor, cell cycle, histone deacetylases, cyclooxygenase-2 (COX-2), or mammalian target of rapamycin (mTOR). This is the first systematic review of the literature to synthesize all available data emerging from trials and evaluate the efficacy and safety of molecularly targeted drugs in cervical cancer. However, it should be stressed that relatively fewer molecularly targeted agents have been tested in cervical cancer in comparison with other cancer types; of note, no related phase 3 trials have been published and consequently no agent has been approved for use in clinical practice. Nevertheless, the promising results of bevacizumab in therapeutic trials for cervical cancer have shown that targeting the VEGF pathway is an attractive therapeutic strategy. As knowledge accumulates on the molecular mechanisms underlying carcinogenesis in the cervix, the anticipated development and assessment of molecularly targeted agents may offer a promising perspective for cervical cancer.
宫颈癌是女性癌症死亡的第三大常见原因。即使采用目前可获得的最佳治疗方法，仍有相当一部分患者会复发并最终死亡。显然，在这种疾病中需要开发具有新作用机制的新药物。目前有许多调节不同信号转导途径的生物制剂正在临床开发中，包括抑制血管生成、针对表皮生长因子受体、细胞周期、组蛋白去乙酰化酶、环氧化酶-2（COX-2）或哺乳动物雷帕霉素靶蛋白（mTOR）。这是对文献进行的首次系统综述，旨在综合所有试验中出现的可用数据，并评估宫颈癌中分子靶向药物的疗效和安全性。然而，应该强调的是，与其他癌症类型相比，在宫颈癌中测试的分子靶向药物相对较少；值得注意的是，尚未发表任何相关的 3 期试验，因此没有药物被批准用于临床实践。然而，贝伐单抗在宫颈癌治疗试验中的有希望的结果表明，靶向 VEGF 途径是一种有吸引力的治疗策略。随着对宫颈致癌机制的分子机制的认识不断增加，预计分子靶向药物的开发和评估可能为宫颈癌提供有希望的前景。
