头颈部鳞状细胞癌中 EGFR-PI3K-AKT-mTOR 通路抑制剂生物标志物的预测价值：系统评价。
Predictive Value of EGFR-PI3K-AKT-mTOR-Pathway Inhibitor Biomarkers for Head and Neck Squamous Cell Carcinoma: A Systematic Review.
机构信息
Department of Pathology, University Medical Center Utrecht, PO Box 885500, 3508 GA, Utrecht, The Netherlands.
Department of Medical Oncology, University Medical Center Utrecht, PO Box 885500, 3508 GA, Utrecht, The Netherlands.
出版信息
Mol Diagn Ther. 2021 Mar;25(2):123-136. doi: 10.1007/s40291-021-00518-6. Epub 2021 Mar 8.
BACKGROUND
Understanding molecular pathogenesis of head and neck squamous cell carcinomas (HNSCC) has considerably improved in the last decades. As a result, novel therapeutic strategies have evolved, amongst which are epidermal growth factor receptor (EGFR)-targeted therapies. With the exception of cetuximab, targeted therapies for HNSCC have not yet been introduced into clinical practice. One important aspect of new treatment regimes in clinical practice is presence of robust biomarkers predictive for therapy response.
METHODS
We performed a systematic search in PubMed, Embase and the Cochrane library. Articles were included if they investigated a biomarker for targeted therapy in the EGFR-PI3K-AKT-mTOR-pathway.
RESULTS
Of 83 included articles, 52 were preclinical and 33 were clinical studies (two studies contained both a preclinical and a clinical part). We classified EGFR pathway inhibitor types and investigated the type of biomarker (biomarker on epigenetic, DNA, mRNA or protein level).
CONCLUSION
Several EGFR-PI3K-AKT-mTOR-pathway inhibitor biomarkers have been researched for HNSCC but few of the investigated biomarkers have been adequately confirmed in clinical trials. A more systematic approach is needed to discover proper biomarkers as stratifying patients is essential to prevent unnecessary costs and side effects.
背景
在过去的几十年中，对头颈鳞状细胞癌（HNSCC）的分子发病机制的理解有了相当大的提高。因此，出现了新的治疗策略，其中包括表皮生长因子受体（EGFR）靶向治疗。除了西妥昔单抗外，针对 HNSCC 的靶向治疗尚未引入临床实践。在临床实践中，新治疗方案的一个重要方面是存在预测治疗反应的强大生物标志物。
方法
我们在 PubMed、Embase 和 Cochrane 图书馆中进行了系统搜索。如果文章研究了针对 EGFR-PI3K-AKT-mTOR 通路的靶向治疗的生物标志物，则将其纳入。
结果
在 83 篇纳入的文章中，52 篇为临床前研究，33 篇为临床研究（两项研究同时包含临床前和临床部分）。我们对 EGFR 通路抑制剂的类型进行了分类，并研究了生物标志物的类型（在表观遗传学、DNA、mRNA 或蛋白质水平上的生物标志物）。
结论
已经研究了几种针对 HNSCC 的 EGFR-PI3K-AKT-mTOR 通路抑制剂生物标志物，但在临床试验中很少有经过充分证实的生物标志物。需要更系统的方法来发现适当的生物标志物，因为对患者进行分层对于防止不必要的成本和副作用至关重要。
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