Nogami Yuya, Banno Kouji, Kisu Iori, Yanokura Megumi, Umene Kiyoko, Masuda Kenta, Kobayashi Yusuke, Yamagami Wataru, Nomura Hiroyuki, Tominaga Eiichiro, Susumu Nobuyuki, Aoki Daisuke
Department of Obstetrics and Gynecology, School of Medicine, Keio University, Shinjuku-ku, Tokyo 1608582, Japan.
Mol Clin Oncol. 2013 Sep;1(5):799-804. doi: 10.3892/mco.2013.140. Epub 2013 Jun 26.
Endometrial cancer is a common gynecological malignant tumor in Western countries and its incidence has also been on the increase in Asia. Genetic abnormalities related to onset and progression of malignancy in the endometrial membrane and signaling system have been identified and the developmental mechanism of endometrial cancer is becoming elucidated. The identification of the molecules related to these abnormalities has led to new potential treatment regimens for endometrial cancer, using molecular-targeted drugs. The current chemotherapy for endometrial cancer often causes systemic side effects that require discontinuation of the treatment. Furthermore, a treatment regimen for cancers of rare histological types has not been established. Recent studies on endometrial cancer revealed patterns of genetic disorders that differ among the histological types. Genetic and molecular information that underlie pathological changes and is associated with DNA mismatch repair genes and epigenetic regulation was also identified. Targeting of these mechanisms with molecular-targeted drugs has been performed with the aim of linking treatment to the carcinogenic mechanism at the molecular and genetic levels. However, the response rates with single-agent therapy are generally low and several problems remain unresolved. Trials of combinations of molecular-targeted drugs with currently available treatments and identification of factors determining sensitivity are required to overcome these difficulties.
子宫内膜癌是西方国家常见的妇科恶性肿瘤,在亚洲其发病率也呈上升趋势。与子宫内膜恶性肿瘤的发生和进展相关的基因异常以及信号系统已被识别,子宫内膜癌的发病机制正逐渐明晰。对与这些异常相关分子的识别,催生了使用分子靶向药物治疗子宫内膜癌的新潜在方案。目前子宫内膜癌的化疗常引发全身性副作用,导致治疗中断。此外,针对罕见组织学类型癌症的治疗方案尚未确立。近期关于子宫内膜癌的研究揭示了不同组织学类型之间存在的基因紊乱模式。还识别出了构成病理变化基础且与DNA错配修复基因及表观遗传调控相关的遗传和分子信息。为了在分子和基因水平上将治疗与致癌机制相联系,已开展针对这些机制的分子靶向药物治疗。然而,单药治疗的有效率普遍较低,仍有若干问题未得到解决。需要进行分子靶向药物与现有治疗方法联合使用的试验,并确定决定敏感性的因素,以克服这些困难。