Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer, WHO, Lyon, France.
Gynecologic Oncology, Tata Medical Center, Kolkata, India.
Int J Gynaecol Obstet. 2018 Oct;143 Suppl 2:131-136. doi: 10.1002/ijgo.12620.
Recent advances in molecular biology of cancer have led to the development of targeted agents, mainly of monoclonal antibodies and small-molecule compounds. Unlike traditional drugs that inhibit DNA synthesis and mitosis, these agents target the signaling pathways of cancer cells, stroma, and vasculature in tumor tissues. For gynecologic cancers, drugs targeting angiogenesis such as anti-VEGF antibody have been used in the treatment of advanced or recurrent ovarian and cervical cancers, and the drugs targeting homologous recombination deficiency such as PARP inhibitors have been approved for maintenance after chemotherapy in platinum-sensitive ovarian cancer. In addition, novel immunotherapy using the immune checkpoint inhibitors such as anti-PD-1 antibody has received much attention for modulation of local immunity, resulting in the durable response of platinum-resistant ovarian cancer. In the precision medicine era, further understanding of cancer genomics and identification of predictive biomarkers are essential to ensure better health for women with gynecologic cancer.
近年来癌症分子生物学的进展导致了靶向药物的发展，主要是单克隆抗体和小分子化合物。与抑制 DNA 合成和有丝分裂的传统药物不同，这些药物针对癌细胞、肿瘤组织中的基质和脉管系统的信号通路。对于妇科癌症，抗血管内皮生长因子（VEGF）抗体等针对血管生成的药物已用于治疗晚期或复发性卵巢癌和宫颈癌，而聚腺苷二磷酸核糖聚合酶（PARP）抑制剂等针对同源重组缺陷的药物已被批准用于铂类敏感卵巢癌的化疗后维持治疗。此外，使用免疫检查点抑制剂（如抗 PD-1 抗体）的新型免疫疗法因其对局部免疫的调节作用而备受关注，从而使铂类耐药性卵巢癌获得持久缓解。在精准医学时代，进一步了解癌症基因组学和识别预测性生物标志物对于确保妇科癌症妇女的健康至关重要。
