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精准医学在神经母细胞瘤中的作用:靶向治疗与个体化方法——叙述性综述

英文原题:The Role of Precision Medicine in Neuroblastoma: Targeted Therapies and Personalized Approaches-A Narrative Review.

PubMed 2026/07/28(内容时间) Health Sci Rep Q1 · IF 2.9(JCR 2025)

研究概要

精准医学通过提高诊断特异性和治疗效果并降低毒性,改变了神经母细胞瘤的治疗。在新兴策略中,ALK靶向治疗和抗GD2免疫治疗显示出强大的临床潜力,尽管仍需进一步验证以改善患病儿童的生存率和生活质量。

研究思路结论见上方概要

神经母细胞瘤是儿童期最常见的颅外实体瘤,也是全球儿童肿瘤死亡的主要原因。其临床表现具有异质性,包括复发,且预后仍然较差,尤其是高危患者。主要干预措施——手术、化疗和放疗——因高发病率和低长期缓解率而加重了预后。本研究试图整合有关神经母细胞瘤遗传和分子特征的现有信息,重点关注精准医学的潜力如何改善神经母细胞瘤的诊断和治疗。

本综述旨在汇编关于神经母细胞瘤及其治疗的基因组学、转录组学和表观遗传学研究的最新文献。综述涵盖了相关通路的最新分子标志物、由此产生的治疗靶点,以及在临床试验各阶段中整合AI、CRISPR和neoantigen疫苗的精准医学方法。

针对MYCN扩增、ALK突变以及包括1p36和11q在内的染色体缺失等靶向药物,已揭示了神经母细胞瘤的重要遗传驱动因素。早期阶段的研究显示,MYCN调节剂、ALK抑制剂和免疫疗法(抗GD2抗体、B7-H3 CAR-T细胞)在减少肿瘤进展方面取得了令人鼓舞的效果。整合基于组学的标志物和AI指导的治疗预测,能够更精确地进行风险分类并定制治疗。

展开英文摘要原文

BACKGROUND AND AIMS: Neuroblastoma is the most common extracranial solid tumor and contributes the most to pediatric oncology deaths worldwide. Its clinical manifestations are heterogeneous, including relapses, and the prognosis remains poor, especially for high-risk patients. The principal interventions-surgery, chemotherapy, and radiotherapy-exacerbate the prognosis due to high morbidity and poor long-term remission rates. This study attempts to integrate available information on the genetic and molecular characteristics of neuroblastoma, focusing on how the potential of precision medicine is improving neuroblastoma diagnosis and treatment. METHODS: This review aims to compile recent literature on the genomic, transcriptomic and epigenetic studies of neuroblastoma and its treatment. The review included the most recent molecular markers for the relevant pathway, the therapeutic targets that arise from them and precision medicine approaches that incorporate AI, CRISPR, and neoantigen vaccines at various stages of clinical trials. RESULTS: Targeted medicines such MYCN amplification, ALK mutations, and chromosomal deletions including 1p36 and 11q have revealed important genetic drivers of neuroblastoma. Early-phase studies have shown encouraging reductions in tumor progression with MYCN modulators, ALK inhibitors and immunotherapies (anti-GD2 antibodies, B7-H3 CAR-T cells). Integrating omics-based markers and AI-directed therapy prediction more precisely classifies risk and customizes therapy. CONCLUSION: Precision medicine has transformed neuroblastoma treatment by improving diagnostic specificity and therapeutic effectiveness while reducing toxicity. Among emerging strategies, ALK-targeted therapies and anti-GD2 immunotherapies show strong clinical potential, although further validation is still required to improve survival and quality of life in affected children.

论文信息

作者
Mawa MJ、Biswas MS、Haque M、Podder MK
第一作者单位
Department of Biochemistry and Biotechnology University of Science & Technology Chittagong (USTC), Foy's Lake Chittagong Bangladesh.
通讯作者单位
Department of Biochemistry and Biotechnology Khwaja Yunus Ali University, Enayetpur Chowhali Bangladesh.
期刊
Health science reports2026 Aug
原文标识
PubMed 42524535 · DOI 10.1002/hsr2.72917