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软组织肉瘤治疗中的精准医学

Precision Medicine in Soft Tissue Sarcoma Treatment.

作者信息

Nakano Kenji, Takahashi Shunji

机构信息

Department of Medical Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.

出版信息

Cancers (Basel). 2020 Jan 16;12(1):221. doi: 10.3390/cancers12010221.

Abstract

Soft tissue sarcoma (STS) is a rare component of malignant diseases. STS includes various histological subtypes, and there are some important differences among the different histological subtypes regarding the mutation profile and sensitivity to antitumor agents. Many clinical trials of STS incorporating many different histological subtypes in various populations have been conducted; it is difficult to compare the findings and make conclusions about clinical efficacy. Targeted therapies focusing on specific histological subtypes and precision therapy focusing on the specific genetic mutation(s) of each STS patient are being investigated. Since STS patients are a small population, new clinical trial designs are required to evaluate and establish new targeted therapies for each histological subtype that has a limited number of patients, and preclinical investigations are needed to detect targetable mutations. Now that cancer genome profiling is used in clinical practice, it is urgently necessary to connect the genome profiling data obtained in clinical settings to the optimal clinical treatment strategies. Herein we review the development and challenges of precision therapy in the management of STS patients.

摘要

软组织肉瘤(STS)是恶性疾病中的一种罕见类型。STS包括多种组织学亚型,不同组织学亚型在突变谱和对抗肿瘤药物的敏感性方面存在一些重要差异。已经开展了许多针对不同人群中包含多种不同组织学亚型的STS临床试验;但比较研究结果并得出关于临床疗效的结论很困难。目前正在研究针对特定组织学亚型的靶向治疗以及针对每个STS患者特定基因突变的精准治疗。由于STS患者群体较小,需要新的临床试验设计来评估并确立针对患者数量有限的每种组织学亚型的新靶向治疗方法,并且需要进行临床前研究以检测可靶向的突变。鉴于癌症基因组分析已应用于临床实践,迫切需要将临床环境中获得的基因组分析数据与最佳临床治疗策略相联系。在此,我们综述了STS患者管理中精准治疗的发展及挑战。

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