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青少年和青年软组织肉瘤的靶向治疗

Targeted therapy for soft tissue sarcomas in adolescents and young adults.

作者信息

Steppan Diana A, Pratilas Christine A, Loeb David M

机构信息

Division of Pediatric Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

出版信息

Adolesc Health Med Ther. 2017 Mar 30;8:41-55. doi: 10.2147/AHMT.S70377. eCollection 2017.

Abstract

Soft tissue sarcomas (STSs) are a heterogeneous group of tumors originating from the mesenchyme. Even though they affect individuals in all age groups, the prevalence of subtypes of STSs changes significantly from childhood through adolescence into adulthood. The mainstay of therapy is surgery, with or without the addition of chemotherapy and/or radiation therapy. These treatment modalities are associated, in many cases, with significant morbidity and, given the heterogeneity of tumor histologies encompassed by the term "STS", have not uniformly improved outcomes. Moreover, some subgroups of STSs appear to be more, and others less, responsive to conventional chemotherapy agents. Over the last two decades, our understanding of the biology of STSs is slowly increasing, allowing for the development of more targeted therapies. We review the new treatment modalities that have been tested on patients with STSs, with a special focus on adolescents and young adults, a group of patients that is often underrepresented in clinical trials and has not received the dedicated attention it deserves, given the significant differences in biology and treatment response in comparison to children and adults.

摘要

软组织肉瘤(STS)是一组起源于间充质的异质性肿瘤。尽管它们影响所有年龄组的个体,但从儿童期到青春期再到成年期,STS各亚型的患病率变化显著。治疗的主要手段是手术,可联合或不联合化疗和/或放疗。在许多情况下,这些治疗方式会带来显著的发病率,并且鉴于“STS”这一术语所涵盖的肿瘤组织学的异质性,治疗效果并未得到一致改善。此外,STS的一些亚组对传统化疗药物的反应似乎更强,而其他亚组则较弱。在过去二十年中,我们对STS生物学的理解正在缓慢增加,从而推动了更具针对性的治疗方法的发展。我们回顾了已在STS患者身上进行测试的新治疗方式,特别关注青少年和青年成人,这一患者群体在临床试验中往往代表性不足,而且由于其生物学特性和治疗反应与儿童及成人存在显著差异,未得到应有的专门关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8d3/5384699/cca7ae946c96/ahmt-8-041Fig1.jpg

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