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年度重大进展:卵巢癌。

Top advances of the year: Ovarian cancer.

机构信息

Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.

National Cancer Institute, Bethesda, Maryland, USA.

出版信息

Cancer. 2024 Mar 15;130(6):837-845. doi: 10.1002/cncr.35135. Epub 2023 Dec 15.

Abstract

Although cure rates remain low and effective screening strategies are elusive, the recent advances in systemic therapies over the past year highlighted in this review have prolonged survival for women with ovarian cancer. In 2022, the first antibody-drug conjugate for platinum-resistant ovarian cancer received accelerated US Food and Drug Administration (FDA) approval. Confirmatory studies examining the efficacy of mirvetuximab and other antibody-drug conjugates are underway. In the upfront setting, the first data establishing an overall survival benefit from poly(ADP-ribose) polymerase inhibitor maintenance was demonstrated after a 7-year follow-up period. In contrast, long-term updates from poly(ADP-ribose) polymerase inhibitor trials in the noncurative setting reported survival detriments, and the FDA withdrew the respective indications. Several trials attempted to improve upon the standard of care for platinum-sensitive ovarian carcinoma and those with rare ovarian cancer histologies (carcinosarcoma, clear cell carcinoma) but failed to demonstrate a clinically or statistically meaningful benefit. This leaves the open question of how to further optimize systemic therapy for advanced ovarian carcinoma to improve long-term survival and cure rates.

摘要

尽管治愈率仍然较低,有效的筛查策略也难以捉摸,但在过去一年中,该综述中强调的系统治疗方面的最新进展延长了卵巢癌患者的生存时间。2022 年,首个用于铂类耐药卵巢癌的抗体药物偶联物获得了美国食品和药物管理局(FDA)的加速批准。正在进行研究 mirvetuximab 和其他抗体药物偶联物疗效的确证性研究。在初始治疗环境中,经过 7 年的随访,首次证明了聚(ADP-核糖)聚合酶抑制剂维持治疗对总生存期有益。相比之下,在非治愈性环境中进行的聚(ADP-核糖)聚合酶抑制剂试验的长期更新报告了生存危害,FDA 撤回了各自的适应证。多项试验试图改进铂类敏感卵巢癌和罕见卵巢癌组织学(癌肉瘤、透明细胞癌)的标准治疗方法,但未能证明具有临床或统计学意义的益处。这就提出了一个悬而未决的问题,即如何进一步优化晚期卵巢癌的系统治疗,以提高长期生存率和治愈率。

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