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乳头状颅咽管瘤的靶向治疗

Targeted therapy of papillary craniopharyngioma.

作者信息

Luo Ning, Lin Yi, Hong Tao, Lin Zhixiong

机构信息

Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Xiangshanyikesong 50#, HaiDian District, Beijing, 100093, China.

Department of Neurosurgery, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330200, Jiangxi, China.

出版信息

Med Oncol. 2025 Jul 22;42(8):367. doi: 10.1007/s12032-025-02920-0.

Abstract

This review provide a comprehensive overview of the molecular biology and therapeutic advances regarding papillary craniopharyngiomas (PCP), with a particular focus on the pivotal role of the BRAF V600E mutation in its pathogenesis. Histopathologically, PCPs are characterized by stratified squamous epithelium and are frequently associated with the BRAF V600E mutation. This mutation activates the MAPK/ERK signaling pathway, which drives tumor development and progression. The identification of this pathway has led to significant progress in targeted therapies, specifically with the use of BRAF and MEK inhibitors, which have demonstrated remarkable efficacy in clinical trials. These inhibitors can effectively reduce tumor size and improve clinical outcomes for patients. However, despite these advancements, there are challenges such as the potential for resistance to these therapies and the management of long-term side effects. Consequently, a multidisciplinary approach that combines surgical resection, radiation therapy, and targeted therapy is often recommended to enhance treatment efficacy although minimizing adverse effects. In addition to adult cases, this review also addresses rare instances of pediatric PCP. Although these cases are infrequent, their molecular characteristics closely resemble those of adult PCP, suggesting that similar therapeutic approaches might be applicable. Looking ahead, future research should focus on optimizing treatment regimens, understanding the interactions within the tumor's immune microenvironment, and identifying novel therapeutic targets. These efforts are crucial for enhancing precision medicine strategies for PCP patients, ultimately improving their quality of life and long-term prognosis. Overall, continued exploration in this field holds promise for more effective and tailored treatment options.

摘要

本综述全面概述了乳头型颅咽管瘤(PCP)的分子生物学和治疗进展,特别关注BRAF V600E突变在其发病机制中的关键作用。在组织病理学上,PCP的特征是分层鳞状上皮,且常与BRAF V600E突变相关。该突变激活MAPK/ERK信号通路,驱动肿瘤的发生和发展。这一信号通路的发现推动了靶向治疗的重大进展,特别是BRAF和MEK抑制剂的使用,它们在临床试验中已显示出显著疗效。这些抑制剂可有效缩小肿瘤大小并改善患者的临床结局。然而,尽管有这些进展,仍存在挑战,如对这些治疗产生耐药性的可能性以及长期副作用的管理。因此,通常建议采用手术切除、放射治疗和靶向治疗相结合的多学科方法,以提高治疗效果,同时尽量减少不良反应。除了成人病例,本综述还讨论了儿童PCP的罕见病例。尽管这些病例并不常见,但其分子特征与成人PCP非常相似,这表明类似的治疗方法可能适用。展望未来,未来的研究应聚焦于优化治疗方案、了解肿瘤免疫微环境中的相互作用以及确定新的治疗靶点。这些努力对于加强PCP患者的精准医疗策略至关重要,最终改善他们的生活质量和长期预后。总体而言,该领域的持续探索有望带来更有效、更具针对性的治疗选择。

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