Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway.
Lancet Oncol. 2012 Aug;13(8):e353-61. doi: 10.1016/S1470-2045(12)70213-9.
Most endometrial carcinomas are diagnosed at an early stage. Still, 15-20% of these carcinomas recur with limited effect of systemic therapies in metastatic disease. Improved ability to target surgical and systemic therapies to well selected patient populations will increase the likelihood of benefits. Retrospective studies have identified several markers for lymph-node metastasis and poor prognosis. No new targeted treatments are available in the clinic, but recent comprehensive molecular characterisations of tumours have identified drugs targeting the PI3K/PTEN/AKT/mTOR pathway and fibroblast growth factor receptor (FGFR) 2 as promising for further studies, also reflected in current clinical trials investigating endometrial carcinoma. A more systematic approach to integration of biomarkers in surgical trials and clinical trials of therapeutics, earlier characterisation and standardisation of diagnostic imaging and biomarker assessment, and prospective implementation studies are needed for clinical implementation. We summarise the present knowledge regarding biomarkers in endometrial carcinoma, assessing how such markers could be applied to address key clinical challenges for the treatment of this disease.
大多数子宫内膜癌在早期被诊断出来。然而，这些癌症中有 15-20%在转移性疾病中复发，全身性治疗效果有限。提高针对手术和全身性治疗的靶向能力，选择合适的患者群体，将增加获益的可能性。回顾性研究已经确定了几个淋巴结转移和预后不良的标志物。目前临床上尚无新的靶向治疗药物，但最近对肿瘤的全面分子特征分析表明，针对 PI3K/PTEN/AKT/mTOR 通路和成纤维细胞生长因子受体 (FGFR)2 的药物具有进一步研究的潜力，这也反映在当前正在进行的子宫内膜癌临床试验中。需要更系统地将生物标志物纳入手术试验和治疗药物临床试验中，更早地对诊断成像和生物标志物评估进行特征描述和标准化，并前瞻性地实施研究，以实现临床应用。我们总结了目前关于子宫内膜癌生物标志物的知识，评估了这些标志物如何应用于解决该疾病治疗的关键临床挑战。
