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胰腺腺癌新型靶向治疗进展

英文原题:Advances in Novel Targeted Therapies for Pancreatic Adenocarcinoma.

查看英文原题

Advances in Novel Targeted Therapies for Pancreatic Adenocarcinoma.

PubMed 2025/01/06(内容时间) J Gastrointest Cancer Q3 · IF 2.2(JCR 2025)

研究概要

靶向治疗的快速演进为抗击胰腺癌——一种历史上预后极差的恶性肿瘤——带来了新的乐观。

中文摘要

目的:胰腺导管腺癌(PDAC)是一种侵袭性很强、治疗选择有限且预后不佳的恶性肿瘤。靶向治疗的近期进展为干预PDAC开辟了新途径,重点针对推动肿瘤进展的关键遗传和分子通路。 方法:本文综述胰腺腺癌新型靶向治疗的进展。 结果:文章探讨了靶向KRAS通路的最新进展。KRAS历来被认为“不可成药”,却是PDAC发病机制中的关键因子。抑制KRAS的策略包括直接靶向KRAS、调节其上游和下游信号、采用KRAS特异性siRNA,以及将KRAS抑制剂与免疫检查点阻断、PARP抑制剂、化疗、CDK4/6抑制剂和自噬调节剂联合的新型方案。除KRAS外,文章还讨论了NRG1融合、NTRK/ROS1融合、RET改变、PRMT5/CDKN2A/MAT2A轴,以及EGFR和Claudin18.2抑制剂等新兴靶点作为有前景治疗策略。此外,综述还介绍微卫星高度不稳定型(MSI-H)PDAC的新方法,以及过继性细胞疗法(CAR-T、TCR、TIL)、癌症疫苗和肿瘤微环境改造等新兴治疗。 结论:总体而言,靶向治疗迅速发展,为治疗传统上预后不佳的胰腺癌带来了新的希望。

展开英文摘要原文

PURPOSE: Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy with limited therapeutic options and poor prognosis. Recent advances in targeted therapies have opened new avenues for intervention in PDAC, focusing on key genetic and molecular pathways that drive tumor progression. METHODS: In this review, we provide an overview on advances in novel targeted therapies in pancreatic adenocarcinoma. RESULTS: Here, we explore the latest development in targeting the KRAS pathway, a historically "undruggable" target crucial to PDAC pathogenesis. Strategies to inhibit KRAS include direct KRAS-targeted therapies, modulation of upstream and downstream signaling, KRAS-specific siRNA, and novel combination therapies integrating KRAS inhibitors with immune checkpoint blockade, PARP inhibitors, chemotherapy, CDK4/6 inhibitors, and autophagy modulators. Beyond KRAS, emerging targets such as NRG1 fusions, NTRK/ROS1 fusions, RET alterations, and the PRMT5/CDKN2A/MAT2A axis, along with EGFR and Claudin18.2 inhibitors, are also discussed as promising therapeutic strategies. Additionally, the review highlights novel approaches for microsatellite instability-high (MSIH) PDAC and emerging therapies, including adoptive cell therapies (CAR-T, TCR, TIL), cancer vaccines, and strategies to modify the tumor microenvironment. CONCLUSION: Overall, the rapid evolution of targeted therapies offers renewed optimism in the fight against pancreatic cancer, a malignancy with historically poor outcomes.

论文信息

作者
Hoang T、Tsang ES
第一作者单位
Department of Medical Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada.Canada
通讯作者单位
Department of Medical Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada. erica.tsang@uhn.ca.Canada
文献类型
综述
期刊
Journal of gastrointestinal cancer2025 Jan 6
原文标识
PubMed 39762686 · DOI 10.1007/s12029-024-01149-w