Kirsanov Kirill I, Lesovaya Ekaterina A, Fetisov Timur I, Bokhyan Beniamin Yu, Belitsky Gennady A, Yakubovskaya Marianna G
N. Blokhin Cancer Research Center, Moscow, Russia.
RUDN University, Moscow, Russia.
Sarcoma. 2020 Mar 31;2020:6716742. doi: 10.1155/2020/6716742. eCollection 2020.
Soft tissue sarcomas (STS) are a highly heterogeneous group of cancers of mesenchymal origin with diverse morphologies and clinical behaviors. While surgical resection is the standard treatment for primary STS, advanced and metastatic STS patients are not eligible for surgery. Systemic treatments, including standard chemotherapy and newer chemical agents, still play the most relevant role in the management of the disease. Discovery of specific genetic alterations in distinct STS subtypes allowed better understanding of mechanisms driving their pathogenesis and treatment optimization. This review focuses on the available targeted drugs or drug combinations based on genetic aberration involved in STS development including chromosomal translocations, oncogenic mutations, gene amplifications, and their perspectives in STS treatment. Furthermore, in this review, we discuss the possible use of chemotherapy sensitivity and resistance assays (CSRA) for the adjustment of treatment for individual patients. In summary, current trends in personalized management of advanced and metastatic STS are based on combination of both genetic testing and CSRA.
软组织肉瘤(STS)是一组高度异质性的间充质起源癌症,具有多样的形态和临床行为。虽然手术切除是原发性STS的标准治疗方法,但晚期和转移性STS患者不符合手术条件。全身治疗,包括标准化疗和新型化学药物,在该疾病的管理中仍发挥着最关键的作用。在不同的STS亚型中发现特定的基因改变,有助于更好地理解驱动其发病机制的因素以及优化治疗方案。本综述重点关注基于参与STS发生发展的基因畸变(包括染色体易位、致癌突变、基因扩增)的可用靶向药物或药物组合,以及它们在STS治疗中的前景。此外,在本综述中,我们讨论了化疗敏感性和耐药性检测(CSRA)在调整个体患者治疗方案方面的可能应用。总之,晚期和转移性STS个性化管理的当前趋势基于基因检测和CSRA的结合。