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东亚妇科肿瘤协作组(EAGOT)的卵巢癌现行治疗策略。

Current treatment strategies for ovarian cancer in the East Asian Gynecologic Oncology Trial Group (EAGOT).

机构信息

Department of Obstetrics and Gynecology, Institute of Medicine, University of Tsukuba, Ibaraki, Japan.

Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Miyagi, Japan.

出版信息

J Gynecol Oncol. 2024 May;35(3):e87. doi: 10.3802/jgo.2024.35.e87. Epub 2024 Apr 3.

Abstract

Ovarian cancer, notable for its severe prognosis among gynecologic cancers, has seen substantial progress in treatment approaches recently. Enhanced protocols in chemotherapy and the introduction of poly (ADP-ribose) polymerase (PARP) inhibitors for maintenance therapy have markedly improved outcomes for patients with specific genetic profiles, such as those positive for BRCA mutations or exhibiting homologous recombination deficiency (HRD). Additionally, the method of intraperitoneal chemotherapy administration has emerged as a valuable alternative to traditional transvenous routes, showing promise for wider clinical adoption. The field of surgery has also evolved, with increasing exploration into the benefits and feasibility of laparoscopic methods over more invasive traditional surgeries, aiming for complete tumor removal but with reduced patient impact. The hereditary nature of ovarian cancer underscores the importance of genetic testing, which has become integral in tailoring treatment strategies, particularly in determining suitability for PARP inhibitors. The formation of the East Asian Gynecologic Oncology Trial Group (EAGOT) aims to optimize treatment across Japan, Korea, China, and Taiwan. The ovarian cancer committee of EAGOT shared the current policies, focusing on 5 topics: 1) strategies for maintenance therapy after initial surgery and chemotherapy, 2) drug regimens for platinum-sensitive and platinum-resistant recurrence, 3) intraperitoneal chemotherapy, 4) laparoscopic surgery as an alternative to laparotomy, and 5) current status of genetic testing (BRCA, HRD, and panel tests) for ovarian cancer and its prospects. EAGOT's multi-national trials aim to harmonize these evolving treatment strategies, ensuring that the latest and most effective protocols are accessible across the region, thereby significantly impacting patient outcomes in East Asia.

摘要

卵巢癌是妇科癌症中预后最差的癌症之一,最近在治疗方法上取得了重大进展。化疗增强方案和聚(ADP-核糖)聚合酶(PARP)抑制剂用于维持治疗,显著改善了具有特定遗传特征的患者的预后,例如 BRCA 突变阳性或表现出同源重组缺陷(HRD)的患者。此外,腹腔内化疗给药方法已成为传统静脉途径的一种有价值的替代方法,有望更广泛地应用于临床。手术领域也在不断发展,越来越多地探索腹腔镜方法相对于更具侵袭性的传统手术的益处和可行性,旨在实现肿瘤完全切除,但患者影响较小。卵巢癌的遗传性突出了基因检测的重要性,基因检测已成为制定治疗策略的重要组成部分,特别是在确定 PARP 抑制剂的适用性方面。东亚妇科肿瘤临床试验组(EAGOT)的成立旨在优化日本、韩国、中国和中国台湾的治疗方案。EAGOT 的卵巢癌委员会分享了当前的政策,重点关注 5 个主题:1)初始手术和化疗后的维持治疗策略,2)铂类敏感和铂类耐药复发的药物方案,3)腹腔内化疗,4)腹腔镜手术作为剖腹手术的替代方法,5)卵巢癌基因检测(BRCA、HRD 和面板检测)的现状及其前景。EAGOT 的多国试验旨在协调这些不断发展的治疗策略,确保该地区能够获得最新和最有效的方案,从而显著影响东亚地区的患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8732/11107282/cdabcac0808e/jgo-35-e87-g001.jpg

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