恶性胶质瘤靶向治疗研究进展

发布时间：2018-07-07 21:15

本文选题：恶性胶质瘤 + 信号通路　；参考：《中华肿瘤防治杂志》2017年05期

【摘要】：目的恶性胶质瘤是一种最常见的原发恶性脑肿瘤,是癌症治疗中最具挑战性疾病之一。因为手术切除后肿瘤易复发和治疗抵抗性,患者预后普遍较差。胶质瘤的分子靶向治疗正逐渐引起广泛关注。本研究总结恶性胶质瘤发病相关的分子病理改变和靶向药物的临床应用与研究进展。方法采用PubMed文献检索系统,以"恶性胶质瘤"和"分子靶向治疗"为关键词,检索2007-01-01-2015-12-31的相关文献。纳入标准:(1)与恶性胶质瘤分子靶向通路相关的文献;(2)与恶性胶质瘤抗血管生成治疗相关的文献;(3)与恶性胶质瘤分子靶向药物的Ⅰ期及Ⅱ期临床研究相关的文献;(4)与恶性胶质瘤分子靶向耐药相关的文献。根据纳入标准分析文献43篇。结果胶质瘤靶向治疗方向主要集中在RTK/RAS/PI3K通路、促血管生成通路和一些其他重要的细胞内信号转导通路。然而,一些因素如信号通路之间的串扰、瘤内异质性和胶质瘤干细胞的治疗抵抗性限制了单一药物的活性。各种分子靶向药物单药治疗未能表现出更好的生存获益,还需与其他治疗方法联合应用。目前对于恶性胶质瘤患者多靶点激酶抑制剂治疗的研究还处于起始阶段。结论分子靶向药物在恶性胶质瘤的治疗中具有重要临床意义和应用潜力,但由于胶质瘤的复杂的分子生物学特性,分子靶向治疗面临诸多挑战,还需进一步探索与研究。
[Abstract]:Objective malignant glioma is one of the most common primary malignant brain tumors and one of the most challenging diseases in cancer treatment. The prognosis of the patients is generally poor because of the recurrence and resistance to treatment after surgical resection. Molecular targeting therapy of glioma is gradually attracting wide attention. This study summarized the molecular pathological changes related to the pathogenesis of malignant gliomas and the clinical application and research progress of targeted drugs. Methods PubMed literature retrieval system was used to search the literature related to "malignant glioma" and "molecular targeted therapy" for 2007-01-2015-12-31. Inclusion criteria: (1) literature related to molecular targeting pathway for malignant gliomas; (2) literature related to antiangiogenic therapy for malignant gliomas; (3) literature related to phase I and phase II clinical studies of molecular targeting drugs for malignant gliomas; (4) Literature related to molecular targeting drug resistance in malignant gliomas. According to the inclusion criteria, 43 articles were analyzed. Results the targeted therapy of glioma mainly focused on RTK / RAS-PI3K pathway, angiogenesis pathway and some other important intracellular signal transduction pathways. However, factors such as crosstalk between signaling pathways, intratumoral heterogeneity and therapeutic resistance to glioma stem cells limit the activity of a single drug. All kinds of molecular targeted drug monotherapy can not show better survival benefit and need to be used in combination with other treatment methods. The study of multi-target kinase inhibitors in malignant gliomas is still in its infancy. Conclusion Molecular targeting drugs have important clinical significance and potential application in the treatment of malignant gliomas. However, due to the complex molecular biological characteristics of gliomas, molecular targeted therapy faces many challenges, which need to be further explored and studied.
【作者单位】：青岛大学附属医院放疗科;
【分类号】：R739.41

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