Bauer S, Dirksen U, Schildhaus H-U
Sarkomzentrum am Westdeutschen Tumorzentrum, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Deutschland.
Innere Klinik/Tumorforschung, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland.
Pathologe. 2019 Jul;40(4):436-442. doi: 10.1007/s00292-019-0628-x.
Diagnostics and treatment of mesenchymal tumors (i.e. soft tissue sarcomas, gastrointestinal stromal tumors, and bone sarcomas) have changed dramatically in the past few years. Molecular and immunohistochemical biomarkers contribute significantly to improved diagnostics. They also play an increasing role in terms of clinical treatment decisions.Grading and tumor type-specific outcome data provide the basis for adjuvant chemotherapy of localized sarcomas. Recurrent gene fusions become more important as predictive biomarkers for targeted therapies in the context of systemic treatments. Immuno-oncology-based approaches are currently being studied in clinical trials, and the first responses of selected patients have been demonstrated. However, the role of predictive biomarkers in this field, such as PD-L1, still needs to be elucidated. Comprehensive genetic analyses of metastatic sarcomas will continue to identify additional therapeutic targets and the corresponding biomarkers.
在过去几年中，间充质肿瘤（即软组织肉瘤、胃肠道间质瘤和骨肉瘤）的诊断和治疗发生了巨大变化。分子和免疫组化生物标志物对改善诊断有显著贡献。它们在临床治疗决策方面也发挥着越来越重要的作用。分级和肿瘤类型特异性结局数据为局限性肉瘤的辅助化疗提供了依据。在全身治疗的背景下，复发性基因融合作为靶向治疗的预测生物标志物变得越来越重要。基于免疫肿瘤学的方法目前正在临床试验中进行研究，并且已证明部分患者有初步反应。然而，预测生物标志物在该领域的作用，如程序性死亡受体配体1（PD-L1），仍有待阐明。转移性肉瘤的全面基因分析将继续识别更多的治疗靶点和相应的生物标志物。
