下一代肿瘤不可知靶点即将出现
Next-generation tumor-agnostic targets on the horizon.
肿瘤不可知药物开发将肿瘤学重新聚焦于共享的分子依赖性而非组织来源,从而能够针对跨肿瘤的罕见可操作驱动因素进行高效开发。
英文原题:The Future of HER2-Targeted Treatment for Osteosarcoma: Lessons from the Negative Trastuzumab Deruxtecan Results.
约 30% 的骨肉瘤患者存在 HER2 过表达,针对骨肉瘤的 HER2 靶向治疗以及 HER2 的预后和/或预测价值也已被研究。
人表皮生长因子受体2(HER2)由原癌基因ERBB编码,在多种恶性疾病中可发生突变或扩增;包括单克隆抗体和小分子酪氨酸激酶抑制剂在内的多种HER2靶向疗法均已开展研究。约30%的骨肉瘤患者存在HER2过表达,HER2在骨肉瘤中的预后和/或预测价值以及HER2靶向治疗也已得到研究。然而,针对骨肉瘤的有效HER2靶向治疗尚未确立。抗体药物偶联物(ADC)曲妥珠单抗德鲁替康(T-DXd)已获批用于乳腺癌和胃癌等HER2阳性恶性肿瘤。T-DXd在一项泛肿瘤临床试验中显示出有前景的疗效,但在HER2阳性骨肉瘤中仍未显示足够疗效。本综述讨论HER2靶向治疗(包括T-DXd)治疗骨肉瘤失败的潜在原因和机制,并阐述HER2靶向治疗的潜力及未来方向。
Human epidermal growth factor receptor 2 (HER2), coded by the proto-oncogene ERBB , is known to be mutated or amplified in various malignant diseases, and many HER2-targeted therapies (including monoclonal antibodies and low-molecular-weight tyrosine kinase inhibitors) have been investigated. HER2 overexpression is observed in ~30% of patients with osteosarcoma, and HER2-targeted therapy for osteosarcoma has also been investigated, along with the prognostic and/or predictive value of HER2. An effective HER2-targeted therapy for osteosarcoma has not been established, however. An antibody-drug conjugate (ADC), i.e., trastuzumab deruxtecan (T-DXd), has been approved for the treatment of HER2-positive malignant diseases such as breast cancer and gastric cancer. T-DXd showed promising efficacy in a tumor-agnostic clinical trial, but even T-DXd did not demonstrate sufficient efficacy against HER2-positive osteosarcoma. In this review, the underlying reasons/mechanisms for the failure of HER2-targeted treatments for osteosarcoma (including T-DXd) are discussed, and the potential and future direction of HER2-targeted therapy is described.
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