Barra Fabio, Lorusso Domenica, Leone Roberti Maggiore Umberto, Ditto Antonino, Bogani Giorgio, Raspagliesi Francesco, Ferrero Simone
a Academic Unit of Obstetrics and Gynecology , IRCCS AOU San Martino - IST , Genoa , Italy.
b Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI) , University of Genoa , Genoa , Italy.
Expert Opin Investig Drugs. 2017 Apr;26(4):389-402. doi: 10.1080/13543784.2017.1302427. Epub 2017 Mar 8.
Cervical cancer (CC) is currently the fourth most common malignant disease of women worldwide. Although the incidence and the mortality rates have been decreasing with screening detection and new treatment strategies, a significant number of metastatic or recurrent disease is still diagnosed. For those patients not amenable to curative treatments, such as surgery and radiation, palliative chemotherapy remains the standard of care. As chemotherapy regimens have limited activity, research is focalized on investigating novel pharmacologic strategies. Areas covered: This paper aims to give a complete and updated overview on investigated therapies for the treatment of CC. The authors review the results of clinical studies and highlight the ongoing trials. Expert opinion: Agents targeting various molecular pathways including epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), mammalian target of rapamycin (mTOR), poly ADP-ribose polymerase (PARP), epigenetics and other biological mechanisms represent interesting investigational opportunities. Amongst such drugs, bevacizumab, an anti-VEGF monoclonal antibody, was the first targeted drug recently approved by the FDA for the treatment of patients with metastatic, recurrent, or persistent CC. Another interesting experimental approach is represented by immunotherapy, which is leading to promising results with to the development of therapeutic vaccines and immune checkpoints inhibitors.
宫颈癌(CC)是目前全球女性中第四大常见恶性疾病。尽管随着筛查检测和新治疗策略的出现,发病率和死亡率一直在下降,但仍有相当数量的转移性或复发性疾病被诊断出来。对于那些不适合进行根治性治疗(如手术和放疗)的患者,姑息化疗仍然是标准治疗方法。由于化疗方案的活性有限,研究集中在探索新的药理学策略上。涵盖领域:本文旨在全面、更新地概述已研究的宫颈癌治疗方法。作者回顾了临床研究结果,并突出了正在进行的试验。专家意见:针对各种分子途径的药物,包括表皮生长因子受体(EGFR)、血管内皮生长因子(VEGF)、雷帕霉素靶蛋白(mTOR)、聚ADP核糖聚合酶(PARP)、表观遗传学和其他生物学机制,代表了有趣的研究机会。在这类药物中,抗VEGF单克隆抗体贝伐单抗是最近美国食品药品监督管理局(FDA)批准用于治疗转移性、复发性或持续性宫颈癌患者的首个靶向药物。另一种有趣的实验方法是免疫疗法,随着治疗性疫苗和免疫检查点抑制剂的开发,免疫疗法正取得有希望的结果。