Tian Zhichao, Yao Weitao
Department of Orthopedics, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China.
Front Pharmacol. 2023 Aug 11;14:1199292. doi: 10.3389/fphar.2023.1199292. eCollection 2023.
Despite the low incidence of soft tissue sarcomas (STSs), hundreds of thousands of new STS cases are diagnosed annually worldwide, and approximately half of them eventually progress to advanced stages. Currently, chemotherapy is the first-line treatment for advanced STSs. There are difficulties in selecting appropriate drugs for multiline chemotherapy, or for combination treatment of different STS histological subtypes. In this study, we first comprehensively reviewed the efficacy of various chemotherapeutic drugs in the treatment of STSs, and then described the current status of sensitive drugs for different STS subtypes. anthracyclines are the most important systemic treatment for advanced STSs. Ifosfamide, trabectedin, gemcitabine, taxanes, dacarbazine, and eribulin exhibit certain activities in STSs. Vinca alkaloid agents (vindesine, vinblastine, vinorelbine, vincristine) have important therapeutic effects in specific STS subtypes, such as rhabdomyosarcoma and Ewing sarcoma family tumors, whereas their activity in other subtypes is weak. Other chemotherapeutic drugs (methotrexate, cisplatin, etoposide, pemetrexed) have weak efficacy in STSs and are rarely used. It is necessary to select specific second- or above-line chemotherapeutic drugs depending on the histological subtype. This review aims to provide a reference for the selection of chemotherapeutic drugs for multi-line therapy for patients with advanced STSs who have an increasingly long survival.
尽管软组织肉瘤(STS)的发病率较低,但全球每年仍有数十万例新的STS病例被诊断出来,其中约一半最终会进展到晚期。目前,化疗是晚期STS的一线治疗方法。在为多线化疗或不同STS组织学亚型的联合治疗选择合适的药物方面存在困难。在本研究中,我们首先全面回顾了各种化疗药物在治疗STS中的疗效,然后描述了不同STS亚型敏感药物的现状。蒽环类药物是晚期STS最重要的全身治疗药物。异环磷酰胺、曲贝替定、吉西他滨、紫杉烷类、达卡巴嗪和艾瑞布林在STS中表现出一定的活性。长春花生物碱类药物(长春地辛、长春碱、长春瑞滨、长春新碱)在特定的STS亚型,如横纹肌肉瘤和尤因肉瘤家族性肿瘤中具有重要的治疗作用,而它们在其他亚型中的活性较弱。其他化疗药物(甲氨蝶呤、顺铂、依托泊苷、培美曲塞)在STS中的疗效较弱,很少使用。有必要根据组织学亚型选择特定的二线及以上化疗药物。这篇综述旨在为生存期越来越长的晚期STS患者多线治疗化疗药物的选择提供参考。