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成人骨肉瘤的新辅助化疗

英文原题:Neoadjuvant Chemotherapy for Adults with Osteogenic Sarcoma.

PubMed 2024/10/17(内容时间) Curr Treat Options Oncol Q1 · IF 5.8(JCR 2025)

研究概要

局限期时 5 年生存率为 65%;然而在转移性疾病病例中,生存率急剧降至 10-20%。

中文摘要

骨肉瘤是青少年和成人中最常见的原发性恶性骨肿瘤。局限性疾病患者的 5 年生存率为 65%;但一旦发生转移,生存率会大幅降至 10%–20%。骨肉瘤治疗在 20 世纪 70 至 80 年代首次取得重大进展,当时确立了目前的标准治疗方案,包括新辅助/辅助甲氨蝶呤、多柔比星(Adriamycin)和顺铂(合称 MAP)治疗及手术切除。自 MAP 方案以来,更优治疗方法的开发停滞,患者结局长期处于平台期,持续了 40 年。尽管针对多种新治疗通路开展了大量研究,临床试验仍未带来显著结局改善。本文讨论当前新辅助标准治疗,并回顾近期治疗选择,包括酪氨酸激酶抑制剂(TKI)、免疫检查点抑制剂(ICI)、单克隆抗体(mAb)和嵌合抗原受体(CAR)T 细胞。最后,我们考察阻碍新治疗选择取得成功的挑战及未来研究方向。

展开英文摘要原文

Osteosarcoma is the most common primary malignant bone tumor in adolescents and adults. The 5-year survival rate is 65% when localized; however, survival drops dramatically to 10-20% in cases of metastatic disease. Therapy for osteosarcoma saw its first significant advancement in the 1970-80's, with the introduction of our current standard of care, consisting of the neo/adjuvant treatment regimen methotrexate, doxorubicin (Adriamycin), and cisplatin (collectively referred to as MAP) and surgical resection. Since MAP, development of a better therapeutic approach has stalled, creating a plateau in patient outcomes that has persisted for 40 years. Despite substantial research into a variety of pathways for novel treatment options, clinical trials have not produced sizeable improvements in outcomes. In this article, we discuss our current neoadjuvant standard of care therapy, followed by a review of contemporary therapeutic options, including tyrosine kinase inhibitors (TKIs), immune checkpoint inhibitors (ICIs), monoclonal antibodies (mAbs), and chimeric antigen receptor (CAR) T cells. Lastly, we consider the challenges hindering the success of novel treatment options and future research directions.

论文信息

作者
Robinson MJ、Davis EJ
第一作者单位
Vanderbilt-Ingram Cancer Center, 2220 Pierce Ave, PRB 777, Nashville, TN, 37232, USA.United States
通讯作者单位
Vanderbilt-Ingram Cancer Center, 2220 Pierce Ave, PRB 777, Nashville, TN, 37232, USA. elizabeth.j.davis@vumc.org.United States
文献类型
综述
期刊
Current treatment options in oncology2024 Nov
原文标识
PubMed 39417976 · DOI 10.1007/s11864-024-01269-2