Diagnostic in Oral Pathology and Oral Medicine Department, School of Dentistry, Universidad de la Republica (UDELAR), Montevideo, Uruguay.
Members of an International Consortium on Odontogenic Tumours.
Oral Dis. 2024 Sep;30(6):3571-3581. doi: 10.1111/odi.14962. Epub 2024 May 1.
Targeted therapy has the potential to be used in the neoadjuvant setting for odontogenic tumors, reducing the morbidities associated with major surgery. In this regard, the aim of this study was to summarize the current evidence on the different forms of targeted therapy, effectiveness, and drawbacks of this course of treatment. Four databases were searched electronically without regard to publication date or language. Grey literature searches and manual searches were also undertaken. Publications with sufficient clinical data on targeted therapy for odontogenic tumors were required to meet the criteria for eligibility. The analysis of the data was descriptive. A total of 15 papers comprising 17 cases (15 ameloblastomas and 2 ameloblastic carcinomas) were included. Numerous mutations were found, with BRAF V600E being most common. Dabrafenib was the most utilized drug in targeted therapy. Except for one case, the treatment reduced the size of the lesion (16/17 cases), showing promise. Most of the adverse events recorded were mild, such as skin issues, voice changes, abnormal hair texture, dry eyes, and systemic symptoms (e.g., fatigue, joint pain, and nausea). It is possible to reach the conclusion that targeted therapy for ameloblastoma and ameloblastic carcinoma may be a useful treatment strategy, based on the findings of the included studies.
靶向治疗有可能在牙源性肿瘤的新辅助治疗中使用，降低大手术相关的发病率。为此，本研究旨在总结不同形式的靶向治疗、有效性和该治疗方案的缺点的现有证据。通过电子方式在不考虑出版日期或语言的情况下对四个数据库进行了检索。还进行了灰色文献检索和手工检索。符合入选标准的出版物必须有足够的牙源性肿瘤靶向治疗的临床数据。数据分析采用描述性方法。共纳入 15 篇文献，包含 17 例（15 例成釉细胞瘤和 2 例成釉细胞癌）。发现了许多突变，最常见的是 BRAF V600E。在靶向治疗中，最常使用的药物是达布拉非尼。除了 1 例外，治疗均使病变缩小（16/17 例），显示出一定的疗效。记录的大多数不良事件为轻度，如皮肤问题、声音改变、异常毛发质地、干眼症和全身症状（如疲劳、关节痛和恶心）。根据纳入研究的结果，可以得出结论，针对成釉细胞瘤和成釉细胞癌的靶向治疗可能是一种有用的治疗策略。
