Sinonasal and Skull Base Tumor Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health; Bethesda, Maryland.
Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, Ohio.
Curr Opin Otolaryngol Head Neck Surg. 2022 Feb 1;30(1):33-39. doi: 10.1097/MOO.0000000000000776.
Sinonasal malignancies are rare and understudied, often diagnosed at late stages, and may behave aggressively. This review explores investigative diagnostic, therapeutic, and scientific advances specific to sinonasal undifferentiated carcinoma (SNUC), intestinal-type adenocarcinoma (ITAC), and olfactory neuroblastoma (ONB).
A number of studies have recently contributed more robust knowledge of the genetic and molecular landscapes of SNUC, ITAC, and ONB. These analyses have identified SMARCB1 and IDH2 mutations in SNUC, potentially allowing for the tumor's subdivision. Recent studies have also defined a role for induction chemotherapy in SNUC. Somatic mutations for ITAC have been identified and may be potentially targetable with FDA approved therapies. Studies defining the tumor microenvironment for ITAC and ONB have introduced the possibility of immune checkpoint inhibition for these tumor types.
Studies reviewed here detail promising results of the most current and novel characterization of SNUC, ITAC, and ONB genetic and molecular landscapes, which have informed ongoing therapeutic discovery. With continued multi-institutional efforts, the field of sinonasal tumor research will achieve higher disease control and improved treatment outcomes for patients afflicted with these rare cancers.
鼻窦恶性肿瘤较为罕见且研究较少,常诊断较晚,且侵袭性较强。本综述探讨了鼻窦未分化癌(SNUC)、肠型腺癌(ITAC)和嗅神经母细胞瘤(ONB)的特定诊断、治疗和科学研究进展。
多项研究最近对 SNUC、ITAC 和 ONB 的遗传和分子图谱有了更深入的了解。这些分析确定了 SNUC 中的 SMARCB1 和 IDH2 突变,可能允许对肿瘤进行细分。最近的研究还确定了诱导化疗在 SNUC 中的作用。已经确定了 ITAC 的体细胞突变,可能可以用 FDA 批准的药物进行靶向治疗。对 ITAC 和 ONB 的肿瘤微环境进行的研究提出了对这些肿瘤类型进行免疫检查点抑制的可能性。
本文综述了 SNUC、ITAC 和 ONB 的遗传和分子图谱的最新和最具创新性的特征,这些特征为正在进行的治疗发现提供了信息。随着多机构的持续努力,鼻窦肿瘤研究领域将实现更高的疾病控制和改善这些罕见癌症患者的治疗结果。