Vornicova Olga, Bar-Sela Gil
a Division of Oncology, Rambam Health Care Campus and Faculty of Medicine , Technion-Israel Institute of Technology , Haifa , Israel.
Expert Opin Investig Drugs. 2016 Jun;25(6):679-86. doi: 10.1517/13543784.2016.1168398. Epub 2016 Apr 7.
Ewing sarcoma family tumors (ESFT) are a group of aggressive diseases, characterized histologically by small, round, blue cells and genetically by translocation involving EWS and ETS partner genes. The current treatment of localized Ewing sarcoma (ES) requires a multi-disciplinary approach, including multidrug chemotherapy, administrated before and after local treatment, surgery and radiation therapy. Unfortunately, the cure rate of metastatic or refractory/recurrent disease is still very poor.
In this review, the authors summarize the new types of therapy and strategies aimed to improve the prognosis or cure ES. Herein, the authors discuss several preclinical and phase I-II studies with new-targeted therapies. The most studied therapies are insulin-like growth factor receptor (IGF1R) inhibitors but have limited efficacy. Other strategies include Mammalian Target of Rapamycin (mTOR) Inhibition, poly ADP ribose polymerase (PARP) inhibition, vascular endothelial growth factor (VEGF) inhibition, tyrosine kinase inhibitors and telomerase inhibitors, all with limited effectiveness.
Future treatment strategies should combine one or more targeted therapies with conventional chemotherapy. Some combined modality treatments are under clinical study. However, treatment breakthroughs are still needed to improve the relatively poor prognosis of recurrent/metastatic ESFT.
尤因肉瘤家族肿瘤(ESFT)是一组侵袭性疾病,组织学上以小的圆形蓝色细胞为特征,遗传学上以涉及EWS和ETS伙伴基因的易位为特征。目前,局限性尤因肉瘤(ES)的治疗需要多学科方法,包括在局部治疗前后进行的多药化疗、手术和放射治疗。不幸的是,转移性或难治性/复发性疾病的治愈率仍然很低。
在本综述中,作者总结了旨在改善ES预后或治愈ES的新型治疗方法和策略。在此,作者讨论了几项针对新靶向治疗的临床前和I-II期研究。研究最多的治疗方法是胰岛素样生长因子受体(IGF1R)抑制剂,但疗效有限。其他策略包括抑制哺乳动物雷帕霉素靶蛋白(mTOR)、抑制聚ADP核糖聚合酶(PARP)、抑制血管内皮生长因子(VEGF)、酪氨酸激酶抑制剂和端粒酶抑制剂,所有这些策略的有效性都有限。
未来的治疗策略应将一种或多种靶向治疗与传统化疗相结合。一些联合治疗方案正在进行临床研究。然而,仍需要治疗突破来改善复发性/转移性ESFT相对较差的预后。