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妊娠滋养细胞肿瘤治疗策略的演变:化疗、免疫治疗和分子靶向治疗。

Evolution of Treatment Strategies for Gestational Trophoblastic Neoplasia: Chemotherapy, Immunotherapy, and Molecular Targeted Therapy.

机构信息

Department of Gynecological Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 250117, P.R. China.

Department of Gynecology, The Second Hospital of Shandong University, Jinan, Shandong, 250033, P.R. China.

出版信息

Curr Treat Options Oncol. 2024 Aug;25(8):1055-1062. doi: 10.1007/s11864-024-01235-y. Epub 2024 Jul 25.

Abstract

In addressing Gestational Trophoblastic Neoplasia (GTN), it is imperative to acknowledge the evolving landscape of treatment options, especially in light of the challenges posed by traditional methods. While historically, surgical interventions, radiation therapy, and chemotherapeutic agents have been the mainstays, the emergence of resistance and high-risk scenarios necessitates a reevaluation of our therapeutic approaches. Our review highlights the promising advancements in immunotherapy and molecular targeted therapy as viable alternatives for GTN management. The introduction of immune checkpoint inhibitors and kinase inhibitors offers a paradigm shift, particularly for patients resistant to conventional chemotherapy regimens. These novel therapies not only exhibit efficacy but also demonstrate manageable toxicity profiles, particularly in high-risk cases. However, integrating these innovative treatments into established international guidelines presents a formidable task. As we move forward, it is imperative that future research not only prioritizes fertility preservation but also rigorously evaluates long-term toxicity implications. International collaboration becomes pivotal in addressing the nuances of this rare and complex disease. In conclusion, our review underscores the need for a nuanced approach to GTN treatment, one that prioritizes reduced toxicity and improved quality of life. By embracing the advancements in immunotherapy and molecular targeted therapy, we can pave the way for more effective and patient-centered care in the management of GTN.

摘要

在处理妊娠滋养细胞肿瘤(GTN)时,必须认识到治疗选择的不断发展,特别是考虑到传统方法所带来的挑战。尽管历史上手术干预、放射治疗和化疗药物一直是主要方法,但耐药性和高危情况的出现需要重新评估我们的治疗方法。我们的综述强调了免疫治疗和分子靶向治疗作为 GTN 管理的可行替代方案的有前途的进展。免疫检查点抑制剂和激酶抑制剂的引入带来了范式转变,特别是对传统化疗方案耐药的患者。这些新疗法不仅显示出疗效,而且毒性谱可管理,特别是在高危情况下。然而,将这些创新疗法纳入既定的国际指南提出了一项艰巨的任务。随着我们的前进,未来的研究不仅必须优先考虑生育力保存,还必须严格评估长期毒性影响。国际合作对于解决这种罕见和复杂疾病的细微差别至关重要。总之,我们的综述强调了需要对 GTN 治疗采取细致入微的方法,优先考虑降低毒性和提高生活质量。通过接受免疫治疗和分子靶向治疗的进步,我们可以为 GTN 管理中更有效和以患者为中心的护理铺平道路。

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