Academic Department of Gynaecology and Obstetrics, Mauriziano Hospital, 10128 Torino, Italy.
Department of Gynecology and Obstetrics, Santa Croce and Carle Hospital, 12100 Cuneo, Italy.
Int J Environ Res Public Health. 2022 Apr 2;19(7):4260. doi: 10.3390/ijerph19074260.
(1) Background: Anthracyclines are intriguing drugs, representing one of the cornerstones of both first and subsequent-lines of chemotherapy in ovarian cancer (OC). Their efficacy and mechanisms of action are related to the hot topics of OC clinical research, such as BRCA status and immunotherapy. Prediction of response to anthracyclines is challenging and no markers can predict certain therapeutic success. The current narrative review provides a summary of the clinical and biological mechanisms involved in the response to anthracyclines. (2) Methods: A MEDLINE search of the literature was performed, focusing on papers published in the last two decades. (3) Results and Conclusions: BRCA mutated tumors seem to show a higher response to anthracyclines compared to sporadic tumors and the severity of hand-foot syndrome and mucositis may be a predictive marker of PLD efficacy. CA125 can be a misleading marker of clinical response during treatment with anthracyclines, the response of which also appears to depend on OC histology. Immunochemistry, in particular HER-2 expression, could be of some help in predicting the response to such drugs, and high levels of mutated p53 appear after exposure to anthracyclines and impair their antitumor effect. Finally, organoids from OC are promising for drug testing and prediction of response to chemotherapy.
(1) 背景：蒽环类药物是一类很有前途的药物，是卵巢癌（OC）一线及二线化疗的基石之一。其疗效和作用机制与 OC 临床研究的热点问题，如 BRCA 状态和免疫治疗相关。预测蒽环类药物的反应具有挑战性，目前尚无标志物可以预测其治疗效果。本综述总结了蒽环类药物反应的临床和生物学机制。(2) 方法：对文献进行了 MEDLINE 检索，重点关注近 20 年来发表的论文。(3) 结果和结论：BRCA 突变肿瘤对蒽环类药物的反应似乎高于散发性肿瘤，手足综合征和黏膜炎的严重程度可能是 PLD 疗效的预测标志物。CA125 可能是蒽环类药物治疗期间临床反应的一个误导性标志物，其反应似乎也取决于 OC 组织学。免疫化学，特别是 HER-2 表达，可能有助于预测此类药物的反应，而蒽环类药物暴露后高突变 p53 水平会损害其抗肿瘤作用。最后，OC 类器官在药物测试和预测化疗反应方面具有广阔的前景。
