Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, 3010, Bern, Switzerland.
, Hamburg, Germany.
J Cancer Res Clin Oncol. 2023 Aug;149(10):8039-8050. doi: 10.1007/s00432-023-04689-z. Epub 2023 Mar 26.
Dysregulated expression of heat shock proteins (HSP) plays a fundamental role in tumor development and progression. Consequently, HSP90 may be an effective tumor target in oncology, including the treatment of gastrointestinal cancers.
We carried out a systematic review of data extracted from clinicaltrials.gov and pubmed.gov, which included all studies available until January 1st, 2022. The published data was evaluated using primary and secondary endpoints, particularly with focus on overall survival, progression-free survival, and rate of stable disease.
Twenty trials used HSP90 inhibitors in GI cancers, ranging from phase I to III clinical trials. Most studies assessed HSP90 inhibitors as a second line treatment. Seventeen of the 20 studies were performed prior to 2015 and only few studies have results pending. Several studies were terminated prematurely, due to insufficient efficacy or toxicity. Thus far, the data suggests that HSP90 inhibitor NVP-AUY922 might improve outcome for colorectal cancer and gastrointestinal stromal tumors.
It currently remains unclear which subgroup of patients might benefit from HSP90 inhibitors and at what time point these inhibitors may be beneficial. There are only few new or ongoing studies initiated during the last decade.
热休克蛋白(HSP)的失调表达在肿瘤的发生和发展中起着根本性的作用。因此,HSP90 可能是肿瘤学中一种有效的肿瘤靶点,包括胃肠道癌的治疗。
我们对 clinicaltrials.gov 和 pubmed.gov 中提取的数据进行了系统回顾,其中包括截至 2022 年 1 月 1 日的所有可用研究。使用主要和次要终点评估已发表的数据,特别是重点关注总生存期、无进展生存期和稳定疾病发生率。
20 项试验在胃肠道癌中使用了 HSP90 抑制剂,涵盖了 I 期至 III 期临床试验。大多数研究将 HSP90 抑制剂评估为二线治疗。20 项研究中有 17 项是在 2015 年之前进行的,只有少数研究的结果仍在等待中。由于疗效不足或毒性,一些研究提前终止。迄今为止,数据表明 HSP90 抑制剂 NVP-AUY922 可能改善结直肠癌和胃肠道间质瘤的预后。
目前尚不清楚哪些亚组患者可能受益于 HSP90 抑制剂,以及这些抑制剂在何时可能有益。在过去十年中,只有少数新的或正在进行的研究启动。