Alldredge Jill K, Tewari Krishnansu S
University of California, Irvine, Orange, California, USA.
University of California, Irvine, Orange, California, USA
Oncologist. 2016 May;21(5):576-85. doi: 10.1634/theoncologist.2015-0393. Epub 2016 Mar 29.
Treatment options for women with metastatic, persistent, or recurrent cervical cancer are limited and thus the disease portends a poor prognosis. It is critical to understand the pathophysiology of cervical cancer to better delineate therapeutic targets. The development of antiangiogenic therapies and their subsequent analysis in rigorous therapeutic trials have redefined current management strategies and is an exciting area of current exploration.
Translational trials have furthered the understanding of molecular determinants of angiogenesis. Phase II trials have shown promising trends with developing antiangiogenic therapies. A practice-changing phase III trial has recently been published. Given the potential benefits and different toxicity spectrum compared with standard cytotoxic chemotherapy, antiangiogenic options are under active investigation for this vulnerable patient population. Emerging data are promising for other antiangiogenic-directed therapeutics, as well as cervical cancer molecular biomarkers to guide diagnosis and treatment.
Antiangiogenic therapies have evolved during the past 20 years and remain an exciting area of current exploration.
Understanding of the angiogenic microenvironment has furthered understanding of tumor biology and management. Antiangiogenic therapies show promise for women with advanced cervical cancer. A review of the evolution of these biologic agents shows them to be an effective and tolerable management strategy for many patients in this vulnerable population, with exciting future potential.
转移性、持续性或复发性宫颈癌女性的治疗选择有限,因此该疾病预后较差。了解宫颈癌的病理生理学对于更好地确定治疗靶点至关重要。抗血管生成疗法的发展及其在严格治疗试验中的后续分析重新定义了当前的管理策略,是当前一个令人兴奋的探索领域。
转化试验进一步加深了对血管生成分子决定因素的理解。II期试验显示了抗血管生成疗法发展的有前景趋势。一项改变实践的III期试验最近已发表。鉴于与标准细胞毒性化疗相比具有潜在益处和不同的毒性谱,抗血管生成方案正在针对这一脆弱患者群体进行积极研究。关于其他抗血管生成导向疗法以及用于指导诊断和治疗的宫颈癌分子生物标志物的新数据很有前景。
抗血管生成疗法在过去20年中不断发展,仍然是当前一个令人兴奋的探索领域。
对血管生成微环境的理解进一步加深了对肿瘤生物学和管理的理解。抗血管生成疗法对晚期宫颈癌女性显示出前景。对这些生物制剂演变的综述表明,它们对这一脆弱人群中的许多患者是一种有效且可耐受的管理策略,具有令人兴奋的未来潜力。