Godinez Christian, Campilan Beatrice, Schroeder Christian, Arditi Jonathan, Michles Madison J, Herrera Benjamín Córdova, Gallagher Kaylee, Robinson Tati-Anna, Owens Tyler, Gokaslan Ziya L, Sullivan Patricia, Martinez-Moreno Margot
Department of Neurosurgery, Warren Alpert Medical School of Brown University, 222 Richmond St, Providence, RI, 02903, USA.
J Neurooncol. 2025 Apr;172(2):307-315. doi: 10.1007/s11060-024-04920-y. Epub 2024 Dec 31.
Chordoma, a rare malignancy of the axial skeleton and skull base, presents significant therapeutic challenges due to the high rates of tumor recurrence and resistance. While surgical resection and radiation therapy remain the gold standard of treatment, the lack of additional treatment options necessitates the exploration of novel therapies. Combinatorial therapies hold significant potential in shaping patient prognosis. By targeting the immunotherapeutic, epigenetic, and genetic landscapes of chordoma, these methods enable the more effective and personalized management of the diverse molecular mechanisms driving chordoma growth and resistance.
To elucidate such potential, we conducted a literature review of all published articles on the usage of immunotherapeutic, epigenetic, and genetic approaches for chordoma treatment from 2014 to 2024.
Eighty-one papers were excluded based on our inclusion criteria. From the remaining thirty-nine publications, we found evidence supporting the efficacy of immune checkpoint inhibitors (ICIs), chimeric antigen receptor (CAR) T-cell therapies, and monoclonal antibodies; the roles of DNA methylation patterns, histone modification pathways, and miRNA regulation; and the contribution of cancer stem-like cells (CSCs) to chordoma progression.
Our findings underscore the importance of a multidirectional approach in chordoma treatment throughout the disease progression to reduce morbidity and improve patient outcomes despite the heterogeneity of chordoma.
脊索瘤是一种罕见的轴向骨骼和颅底恶性肿瘤，由于肿瘤复发率高和耐药性，带来了重大的治疗挑战。虽然手术切除和放射治疗仍然是治疗的金标准，但缺乏其他治疗选择使得探索新疗法成为必要。联合疗法在塑造患者预后方面具有巨大潜力。通过针对脊索瘤的免疫治疗、表观遗传和基因格局，这些方法能够更有效且个性化地管理驱动脊索瘤生长和耐药的多种分子机制。
为了阐明这种潜力，我们对2014年至2024年期间所有已发表的关于免疫治疗、表观遗传和基因方法用于脊索瘤治疗的文章进行了文献综述。
根据我们的纳入标准，排除了81篇论文。从其余39篇出版物中，我们发现了支持免疫检查点抑制剂（ICIs）、嵌合抗原受体（CAR）T细胞疗法和单克隆抗体疗效的证据；DNA甲基化模式、组蛋白修饰途径和miRNA调控的作用；以及癌症干细胞样细胞（CSCs）对脊索瘤进展的贡献。
我们的研究结果强调了在脊索瘤疾病进展过程中采用多方向治疗方法的重要性，尽管脊索瘤具有异质性，但仍可降低发病率并改善患者预后。
