破坏 DNA 损伤反应以改善宫颈癌治疗。

Breaking the DNA damage response to improve cervical cancer treatment.

机构信息

Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Gynecologic Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Department of Gynecologic Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

出版信息

Cancer Treat Rev. 2016 Jan;42:30-40. doi: 10.1016/j.ctrv.2015.11.008. Epub 2015 Nov 24.

Abstract

Every year, cervical cancer affects ∼500,000 women worldwide, and ∼275,000 patients die of this disease. The addition of platin-based chemotherapy to primary radiotherapy has increased 5-year survival of advanced-stage cervical cancer patients, which is, however, still only 66%. One of the factors thought to contribute to treatment failure is the ability of tumor cells to repair chemoradiotherapy-induced DNA damage. Therefore, sensitization of tumor cells for chemoradiotherapy via inhibition of the DNA damage response (DDR) as a novel strategy to improve therapy effect, is currently studied pre-clinically as well as in the clinic. Almost invariably, cervical carcinogenesis involves infection with the human papillomavirus (HPV), which inactivates part of the DNA damage response. This HPV-mediated partial inactivation of the DDR presents therapeutic targeting of the residual DDR as an interesting approach to achieve chemoradio-sensitization for cervical cancer. How the DDR can be most efficiently targeted, however, remains unclear. The fact that cisplatin and radiotherapy activate multiple signaling axes within the DDR further complicates a rational choice of therapeutic targets within the DDR. In this review, we provide an overview of the current preclinical and clinical knowledge about targeting the DDR in cervical cancer.

摘要

每年,全球有约 50 万名妇女罹患宫颈癌,约 27.5 万名患者死于该病。在原发性放疗中加入铂类化疗提高了晚期宫颈癌患者的 5 年生存率,但仍仅为 66%。被认为导致治疗失败的因素之一是肿瘤细胞修复放化疗诱导的 DNA 损伤的能力。因此,通过抑制 DNA 损伤反应 (DDR) 使肿瘤细胞对放化疗敏感,作为一种提高治疗效果的新策略,目前正在临床前和临床研究中进行。几乎无一例外的是,宫颈癌的发生涉及人乳头瘤病毒 (HPV) 的感染,HPV 使部分 DDR 失活。HPV 介导的 DDR 部分失活为实现宫颈癌的放化疗增敏提供了靶向残留 DDR 的有趣方法。然而,如何最有效地靶向 DDR 仍不清楚。顺铂和放疗激活 DDR 内的多个信号通路,这进一步使 DDR 内的治疗靶点的合理选择变得复杂。在这篇综述中,我们概述了目前关于宫颈癌中靶向 DDR 的临床前和临床知识。

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