Grünewald T G P
Max-Eder Nachwuchsgruppe für Pädiatrische Sarkombiologie, Pathologisches Institut, Medizinische Fakultät, LMU München, Thalkirchner Str. 36, 80337, München, Deutschland.
Pathologe. 2017 Nov;38(Suppl 2):198-201. doi: 10.1007/s00292-017-0332-7.
Ewing sarcoma is a highly aggressive bone or soft-tissue tumor mostly occurring in children and adolescents. Conventional multi-modal therapies are associated with considerable acute and chronic toxicity. Thus, more effective and in particular less toxic therapeutic strategies are urgently required. Despite the fact that Ewing sarcoma is characterized by specific EWSR1-ETS gene fusions, the resulting fusion oncoproteins are not suitable for targeted therapy due to their low immunogenicity and the ubiquitous expression of their constituents. However, functional genomics revealed several EWSR1-ETS target genes, which are only minimally expressed in normal tissues, and which could serve as surrogate-targets for (immuno-)therapeutic approaches. Moreover, functional genomic analyses yielded first mechanistic explanations for the relatively high incidence of Ewing sarcoma in Europeans, and first studies are exploring the value of circulating free DNA and/or exosomal mRNA of EWSR1-ETS fusion oncogenes as minimal-residual-disease markers in Ewing sarcoma. This review summarizes key contributions to these aspects and gives a perspective on their medical relevance.
尤因肉瘤是一种侵袭性很强的骨或软组织肿瘤,主要发生于儿童和青少年。传统的多模式疗法会带来相当大的急慢性毒性。因此,迫切需要更有效、尤其是毒性更低的治疗策略。尽管尤因肉瘤具有特定的EWSR1-ETS基因融合特征,但由于其免疫原性低且其组成成分普遍表达,由此产生的融合癌蛋白并不适合靶向治疗。然而,功能基因组学揭示了几个EWSR1-ETS靶基因,这些基因在正常组织中表达极低,可作为(免疫)治疗方法的替代靶点。此外,功能基因组分析对欧洲人尤因肉瘤发病率相对较高给出了初步的机制解释,并且初步研究正在探索EWSR1-ETS融合癌基因的循环游离DNA和/或外泌体mRNA作为尤因肉瘤微小残留病标志物的价值。本综述总结了这些方面的关键贡献,并对其医学相关性给出了展望。