研究概要
神经母细胞瘤(NB)是儿童最常见的颅外肿瘤,也是儿童癌症死亡的第三大原因。
中文摘要
神经母细胞瘤(NB)是儿童最常见的颅外肿瘤,也是儿童癌症死亡的第三大原因。尽管低危和中危患者的总体生存率较高,但高危病例的生存率仍不令人满意。目前高危NB的标准治疗包括手术、化疗、放疗、自体干细胞移植、抗神经节苷脂GD2免疫治疗以及异维A酸分化治疗。这些治疗不仅不足以在高危患者中实现高生存率,还伴随着显著的副作用。随着下一代测序技术的发展,人们对NB的遗传和表观遗传景观有了更深入的了解。这促进了对新型治疗的研究,以提高高危NB的总体生存率并降低传统治疗的毒性。当前的研究聚焦于针对遗传和表观遗传改变的靶向药物以及蛋白质降解剂的开发。此外,正在探索通过增强抗癌免疫反应的免疫治疗以及利用嵌合抗原受体(CAR)T细胞和NK细胞的细胞工程技术来靶向NB细胞。在此,我们综述了针对NB的有前景的新型治疗策略,这些策略靶向遗传学、表观遗传学、肿瘤微环境和免疫景观,并重点介绍了临床前研究和正在进行的临床试验。
展开英文摘要原文
Neuroblastoma (NB) is the most prevalent extracranial childhood tumor and the third leading cause of death from cancer in children. Despite having a high overall survival rate for low- and intermediate-risk patients, survival rates for high-risk cases remain unsatisfactory. The current standard treatment for high-risk NB involves surgery, chemotherapy, radiotherapy, autologous stem cell transplantation, immunotherapy with anti-ganglioside GD2, and differentiation therapy with isotretinoin. Besides not being enough to achieve a high survival rate in high-risk patients, these treatments are associated with significant side effects. With next-generation sequencing technologies, a better understanding of the genetic and epigenetic landscapes of NB has been achieved. This has led to the study of novel treatments to improve the overall survival rate of high-risk NB and reduce the toxicity of conventional treatments. Current research is focusing on the development of targeted drugs for genetic and epigenetic alterations, and protein degraders. Moreover, immunotherapy to enhance anticancer immune responses and by using cell-engineering techniques with chimeric antigen receptor (CAR) T and NK cells are being explored to target NB cells. Here, we review promising novel treatment strategies for NB, which target genetics, epigenetics, the tumor microenvironment, and the immune landscape, highlighting preclinical studies and ongoing clinical trials.
论文信息
- 作者
- Andrade-Perez V、Raynal NJ
- 单位
- Département de Pharmacologie et Physiologie, Faculté de Médecine, Université de Montréal, Montréal, QC H3T 1C5, Canada.Canada
- 文献类型
- 综述
- 期刊
- Cancers2025 May 29