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将成功的生殖细胞肿瘤模式应用于常见成人实体癌的挑战

Application of a Successful Germ Cell Tumor Paradigm to the Challenges of Common Adult Solid Cancers.

作者信息

Tu Shi-Ming, Campbell Matthew, Shah Amishi, Logothetis Christopher J

机构信息

Department of Genitourinary, Medical Oncology University of Texas MD Anderson Cancer Center, 1155 Pressler Street Houston, TX 77030-372, United States.

出版信息

J Cell Sci Ther. 2021;12(6).

Abstract

When we aspire to cure cancer, we may need to search no further than a curable cancer, such as Germ Cell Tumor of the Testis (TGCT). After all, a germ cell is a primordial stem cell. Importantly, TGCT provides a classic stem cell model of cancer that teaches us some invaluable lessons about curing other intractable solid tumors. The intrinsic intratumoral heterogeneity of TGCT alludes to its stem-ness origin and nature. Which implicates the existence of putative lethal TGCT subtypes-the identification and detection of which may further enhance the cure rate and improve the therapeutic ratio of TGCT. In this Mini review, we discuss about the role of biologic insights, clinical lessons, and therapeutic strategies in drug and therapy development. We illustrate some clinical pearls and perils when it concerns drug versus therapy development in the cure and care of patients with TGCT. In many respects, we have cured more TGCT patients when we apply multimodal therapy rather than targeted therapy and integrated medicine rather than precision medicine. In principle and in practice, this is the implication of therapy versus drug development in improving the overall outcome and cure rate of patients with cancer.

摘要

当我们渴望治愈癌症时,或许无需再寻找比可治愈癌症,如睾丸生殖细胞肿瘤(TGCT)更好的例子了。毕竟,生殖细胞是一种原始干细胞。重要的是,TGCT提供了一个经典的癌症干细胞模型,能让我们学到一些关于治愈其他难治性实体瘤的宝贵经验。TGCT内在的肿瘤内异质性暗示了其干细胞起源和性质。这意味着可能存在潜在致命的TGCT亚型——对其进行识别和检测可能会进一步提高TGCT的治愈率并改善治疗效果。在这篇小型综述中,我们讨论生物学见解、临床经验以及治疗策略在药物和治疗方法开发中的作用。我们阐述了在TGCT患者的治愈和护理中,涉及药物研发与治疗方法开发时的一些临床要点和风险。在很多方面,当我们应用多模式治疗而非靶向治疗、采用整合医学而非精准医学时,我们治愈了更多的TGCT患者。在理论和实践中,这就是治疗方法研发与药物研发对提高癌症患者总体治疗效果和治愈率的意义所在。

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