Suh Dong Hoon, Kim Miseon, Kim Kidong, Kim Hak Jae, Lee Kyung Hun, Kim Jae Weon
Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.
J Gynecol Oncol. 2017 May;28(3):e45. doi: 10.3802/jgo.2017.28.e45. Epub 2017 Mar 24.
In 2016, 13 topics were selected as major research advances in gynecologic oncology. For ovarian cancer, study results supporting previous ones regarding surgical preventive strategies were reported. There were several targeted agents that showed comparable responses in phase III trials, including niraparib, cediranib, and nintedanib. On the contrary to our expectations, dose-dense weekly chemotherapy regimen failed to prove superior survival outcomes compared with conventional triweekly regimen. Single-agent non-platinum treatment to prolong platinum-free-interval in patients with recurrent, partially platinum-sensitive ovarian cancer did not improve and even worsened overall survival (OS). For cervical cancer, we reviewed robust evidences of larger-scaled population-based study and cost-effectiveness of nonavalent vaccine for expanding human papillomavirus (HPV) vaccine coverage. Standard of care treatment of locally advanced cervical cancer (LACC) was briefly reviewed. For uterine corpus cancer, new findings about appropriate surgical wait time from diagnosis to surgery were reported. Advantages of minimally invasive surgery over conventional laparotomy were reconfirmed. There were 5 new gene regions that increase the risk of developing endometrial cancer. Regarding radiation therapy, Post-Operative Radiation Therapy in Endometrial Cancer (PORTEC)-3 quality of life (QOL) data were released and higher local control rate of image-guided adaptive brachytherapy was reported in LACC. In addition, 4 general oncology topics followed: chemotherapy at the end-of-life, immunotherapy with reengineering T-cells, actualization of precision medicine, and artificial intelligence (AI) to make personalized cancer therapy real. For breast cancer, adaptively randomized trials, extending aromatase inhibitor therapy, and ribociclib and palbociclib were introduced.
2016年,13个主题被选为妇科肿瘤学的主要研究进展。对于卵巢癌,报告了支持先前关于手术预防策略研究结果的研究成果。有几种靶向药物在III期试验中显示出相似的反应,包括尼拉帕尼、西地尼布和尼达尼布。与我们的预期相反,与传统的每三周一次的化疗方案相比,剂量密集的每周化疗方案未能证明具有更好的生存结果。对于复发性、部分铂敏感的卵巢癌患者,采用单药非铂治疗以延长无铂间期并不能改善甚至恶化总生存期(OS)。对于宫颈癌,我们回顾了大规模基于人群的研究的有力证据以及九价疫苗在扩大人乳头瘤病毒(HPV)疫苗接种覆盖率方面的成本效益。简要回顾了局部晚期宫颈癌(LACC)的标准治疗。对于子宫体癌,报告了关于从诊断到手术的适当手术等待时间的新发现。再次证实了微创手术相对于传统剖腹手术的优势。有5个新的基因区域会增加患子宫内膜癌的风险。关于放射治疗,发布了子宫内膜癌术后放射治疗(PORTEC)-3生活质量(QOL)数据,并报告了LACC中图像引导适应性近距离放射治疗的局部控制率更高。此外,还介绍了4个一般肿瘤学主题:临终化疗、重新设计T细胞的免疫疗法、精准医学的实现以及使个性化癌症治疗成为现实的人工智能(AI)。对于乳腺癌,介绍了适应性随机试验、延长芳香化酶抑制剂治疗以及瑞博西尼和哌柏西利。