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胆管癌:从临床前到临床开发的转化差距及对未来治疗的影响。

Cholangiocarcinoma: bridging the translational gap from preclinical to clinical development and implications for future therapy.

机构信息

Liver Unit, Department of Medicine, University of Rome Tor Vergata, Rome, Italy.

Hepatology and Gastroenterology, Medicine, Indiana University, Indianapolis, IN, USA.

出版信息

Expert Opin Investig Drugs. 2021 Apr;30(4):365-375. doi: 10.1080/13543784.2021.1854725. Epub 2020 Dec 8.

Abstract

: Cholangiocarcinoma (CCA) is a devastating liver tumor with a poor prognosis. While less than 50% of the patients with CCA may benefit from surgical resection, the rest undergoes chemotherapy with disappointing results (mean survival <2 years). Alternative pharmacological treatments are needed to improve the outcomes in patients with CCA.: In this review, we discuss CCA-related (1) experimental systems used in preclinical studies; (2) pharmacological targets identified by genetic analysis; (3) results obtained in preliminary trials in human with their pros and cons; and (4) possible targeting of endocrinal modulation. A PubMed bibliographic search matching the term 'cholangiocarcinoma' with 'experimental model', 'preclinical model', 'genetic target', 'targeted therapy', 'clinical trial', or 'translational research' was conducted and manuscripts published between 2010 and 2020 were retrieved for reading and reviewing.: Several factors contribute to the translational gap between bench research and clinical practice in CCA. The tumor heterogeneity, lack of a preclinical model recapitulating the different features of CCA, and difficult patient enrollment in clinical trials are elements to consider for basic and clinical research in CCA. Establishment of international networks formed by experts in the field of CCA may improve future research and its translational findings on patients.

摘要

胆管癌(CCA)是一种预后不良的致命肝肿瘤。尽管不到 50%的 CCA 患者可能从手术切除中受益,但其余患者则接受化疗,效果令人失望(平均生存时间<2 年)。需要替代的药物治疗方法来改善 CCA 患者的预后。

在这篇综述中,我们讨论了与 CCA 相关的:(1)临床前研究中使用的实验系统;(2)通过遗传分析确定的药理靶点;(3)在人类中进行初步试验的结果及其优缺点;以及(4)内分泌调节的可能靶向性。我们进行了一项 PubMed 文献检索,使用术语“胆管癌”与“实验模型”、“临床前模型”、“遗传靶点”、“靶向治疗”、“临床试验”或“转化研究”进行匹配,并检索了 2010 年至 2020 年发表的文献进行阅读和回顾。

有几个因素导致 CCA 中基础研究与临床实践之间存在转化差距。肿瘤异质性、缺乏能够重现 CCA 不同特征的临床前模型,以及临床试验中患者入组困难,这些都是 CCA 基础和临床研究需要考虑的因素。由 CCA 领域专家组成的国际网络的建立可能会改善未来针对患者的研究及其转化发现。

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本文引用的文献

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Evolution of the Experimental Models of Cholangiocarcinoma.胆管癌实验模型的演变
Cancers (Basel). 2020 Aug 17;12(8):2308. doi: 10.3390/cancers12082308.
8
Cholangiocarcinoma 2020: the next horizon in mechanisms and management.胆管癌 2020:机制和管理的新前沿。
Nat Rev Gastroenterol Hepatol. 2020 Sep;17(9):557-588. doi: 10.1038/s41575-020-0310-z. Epub 2020 Jun 30.
10
The Tumor Microenvironment in Cholangiocarcinoma Progression.胆管癌进展中的肿瘤微环境。
Hepatology. 2021 Jan;73 Suppl 1(Suppl 1):75-85. doi: 10.1002/hep.31410. Epub 2020 Nov 6.

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