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乳腺癌中的诊疗一体化

Theranostics in breast cancer.

作者信息

Vorster M, Hadebe B P, Sathekge M M

机构信息

Department of Nuclear Medicine, University of KwaZulu-Natal, Durban, South Africa.

Department of Nuclear Medicine, University of Pretoria, Pretoria, South Africa.

出版信息

Front Nucl Med. 2023 Aug 4;3:1236565. doi: 10.3389/fnume.2023.1236565. eCollection 2023.

Abstract

INTRODUCTION

Breast cancer is a complex disease and constitutes the leading cause of cancer in women globally. Conventional treatment modalities include surgery, chemotherapy, radiation therapy, and hormonal therapy; all of these have their limitations and often result in significant side effects or toxicity. Targeted radionuclide therapy based on a theranostic approach has been successfully applied in several malignancies, such as prostate cancer, thyroid cancer, and neuro-endocrine tumours. Several studies have also highlighted the potential of theranostic applications in breast cancer.

AIM

This review aims to provide an overview of the most promising current and future theranostic approaches in breast cancer.

DISCUSSION

The discussion includes pre-clinical as well as clinical data on some of the most successful targets used to date. Examples of potential theranostic approaches include those targeting the Human epidermal growth factor receptor 2 (HER2) expression, angiogenesis, aspects of the tumour microenvironment, Gastrin-releasing peptide receptor (GRPR), Prostate-specific membrane antigen (PSMA) and Chemokine receptor 4 (CXCR-4) expression. Several challenges to widespread clinical implementation remain, which include regulatory approval, access to the various radiopharmaceuticals and imaging technology, cost-effectiveness, and the absence of robust clinical data.

CONCLUSION

Theranostic approaches have the potential to greatly improve diagnosis, treatment, and outcomes for patients with breast cancer. More research is needed to fully explore the potential of such approaches and to identify the best potential targets, considering feasibility, costs, efficacy, side effects and outcomes.

摘要

引言

乳腺癌是一种复杂的疾病,是全球女性癌症的主要病因。传统的治疗方式包括手术、化疗、放疗和激素疗法;所有这些方法都有其局限性,并且常常会导致显著的副作用或毒性。基于诊疗一体化方法的靶向放射性核素治疗已成功应用于多种恶性肿瘤,如前列腺癌、甲状腺癌和神经内分泌肿瘤。多项研究也强调了诊疗一体化应用在乳腺癌中的潜力。

目的

本综述旨在概述目前及未来在乳腺癌中最具前景的诊疗一体化方法。

讨论

讨论内容包括迄今为止一些最成功靶点的临床前及临床数据。潜在的诊疗一体化方法示例包括针对人表皮生长因子受体2(HER2)表达、血管生成、肿瘤微环境方面、胃泌素释放肽受体(GRPR)、前列腺特异性膜抗原(PSMA)和趋化因子受体4(CXCR-4)表达的方法。广泛临床应用仍面临若干挑战,包括监管批准、获取各种放射性药物和成像技术、成本效益以及缺乏有力的临床数据。

结论

诊疗一体化方法有潜力极大地改善乳腺癌患者的诊断、治疗及预后。需要开展更多研究以充分探索此类方法的潜力,并考虑可行性、成本、疗效、副作用及预后等因素来确定最佳潜在靶点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec7f/11440857/b13b3d341340/fnume-03-1236565-g001.jpg

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