Rodriguez-Freixinos Victor, Karakasis Katherine, Oza Amit M
Department of Medicine, Division of Medical Oncology, Princess Margaret Cancer Center, University of Toronto, Toronto, ON, Canada.
Princess Margaret Cancer Center, Bras Family Drug Development Program, 610 University Avenue, Toronto, ON, M5G 2M9, Canada.
Curr Oncol Rep. 2016 Apr;18(4):23. doi: 10.1007/s11912-016-0507-z.
Endometrial cancer is the most common gynecological malignancy in Europe and North America. Metastatic and recurrent disease is generally incurable with poor prognosis. Recent advances in molecular profiling of endometrial cancer have elucidated four distinct molecular subtypes with different biology and prognosis which should facilitate the development of treatments tailored to disease-specific subgroups. To date, some molecular-targeted agents have shown interesting clinical activity in the recurrent setting, but no targeted therapies are approved for endometrial cancer. Novel pan-PI3K, AKT, and dual PI3K-mTOR inhibitors are being investigated with early signs of activity, but there are concerns about tolerability and toxicity in this often elderly patient population with comorbidities. The development of anti-angiogenic therapies, PARP inhibitors, and immunotherapies, alone or in combinations, appear to be promising strategies. This paper will describe the current evidence supporting the efficacy of molecular-targeted agents already tested in the treatment of metastatic and recurrent EC, and provide some insights on emerging data related to novel-targeted therapies.
子宫内膜癌是欧洲和北美的最常见妇科恶性肿瘤。转移性和复发性疾病通常无法治愈，预后较差。子宫内膜癌分子图谱的最新进展阐明了四种不同的分子亚型，它们具有不同的生物学特性和预后，这将有助于开发针对特定疾病亚组的治疗方法。迄今为止，一些分子靶向药物在复发性疾病中已显示出有趣的临床活性，但尚无针对子宫内膜癌的靶向治疗药物获批。新型泛PI3K、AKT及双PI3K-mTOR抑制剂正在研究中，已出现早期活性迹象，但对于这个常伴有合并症的老年患者群体，人们担心其耐受性和毒性。抗血管生成疗法、PARP抑制剂及免疫疗法单独或联合使用，似乎都是很有前景的策略。本文将描述目前支持已在转移性和复发性子宫内膜癌治疗中进行测试的分子靶向药物疗效的证据，并对与新型靶向疗法相关的新出现数据提供一些见解。
