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表皮生长因子受体抑制剂在脑胶质瘤中的应用:现状与未来可能。

Epidermal Growth Factor Receptor Inhibitors in Glioblastoma: Current Status and Future Possibilities.

机构信息

California Northstate University College of Medicine, Elk Grove, CA 95757, USA.

Reynolds Institute on Aging, Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.

出版信息

Int J Mol Sci. 2024 Feb 15;25(4):2316. doi: 10.3390/ijms25042316.

Abstract

Glioblastoma, a grade 4 glioma as per the World Health Organization, poses a challenge in adult primary brain tumor management despite advanced surgical techniques and multimodal therapies. This review delves into the potential of targeting epidermal growth factor receptor (EGFR) with small-molecule inhibitors and antibodies as a treatment strategy. EGFR, a mutationally active receptor tyrosine kinase in over 50% of glioblastoma cases, features variants like EGFRvIII, EGFRvII and missense mutations, necessitating a deep understanding of their structures and signaling pathways. Although EGFR inhibitors have demonstrated efficacy in other cancers, their application in glioblastoma is hindered by blood-brain barrier penetration and intrinsic resistance. The evolving realm of nanodrugs and convection-enhanced delivery offers promise in ensuring precise drug delivery to the brain. Critical to success is the identification of glioblastoma patient populations that benefit from EGFR inhibitors. Tools like radiolabeled anti-EGFR antibody 806i facilitate the visualization of EGFR conformations, aiding in tailored treatment selection. Recognizing the synergistic potential of combination therapies with downstream targets like mTOR, PI3k, and HDACs is pivotal for enhancing EGFR inhibitor efficacy. In conclusion, the era of precision oncology holds promise for targeting EGFR in glioblastoma, contingent on tailored treatments, effective blood-brain barrier navigation, and the exploration of synergistic therapies.

摘要

胶质母细胞瘤是一种 4 级神经胶质瘤,按照世界卫生组织的分类标准,尽管采用了先进的手术技术和多模式治疗方法,它仍然是成人原发性脑肿瘤管理中的一个挑战。本综述深入探讨了使用小分子抑制剂和抗体靶向表皮生长因子受体 (EGFR) 作为治疗策略的潜力。在超过 50%的胶质母细胞瘤病例中,EGFR 是一种突变激活的受体酪氨酸激酶,具有 EGFRvIII、EGFRvII 和错义突变等变体,因此需要深入了解它们的结构和信号通路。尽管 EGFR 抑制剂在其他癌症中已显示出疗效,但由于血脑屏障的穿透性和内在耐药性,其在胶质母细胞瘤中的应用受到限制。纳米药物和对流增强递送的不断发展领域为确保精确将药物递送到大脑提供了希望。成功的关键是确定从 EGFR 抑制剂中受益的胶质母细胞瘤患者人群。放射性标记的抗 EGFR 抗体 806i 等工具有助于可视化 EGFR 构象,从而有助于选择量身定制的治疗方法。认识到与下游靶点如 mTOR、PI3k 和 HDACs 的联合治疗的协同潜力对于提高 EGFR 抑制剂的疗效至关重要。总之,精准肿瘤学的时代为靶向胶质母细胞瘤中的 EGFR 提供了希望,但需要针对特定的治疗方法、有效的血脑屏障导航以及探索协同治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d323/10889328/4270dc89b286/ijms-25-02316-g001.jpg

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