Targeted Therapies and Predictive Markers in Epithelial Malignancies of the Gastrointestinal Tract
Targeted Therapies and Predictive Markers in Epithelial Malignancies of the Gastrointestinal Tract
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DOI：
10.5858/arpa.2011-0167-ra
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发表时间：
2012-05-01
影响因子：
4.6
通讯作者：
Redston, Mark
中科院分区：
文献类型：
--
作者：
McIntire, Maria;Redston, Mark
上下文。近年来，人们对开发治疗人类癌症的靶向疗法产生了极大的兴趣。对特定分子途径和对癌细胞生长至关重要的驱动突变的了解增加，使得这些先进治疗方法得以发展。其中，表皮生长因子受体和HER2/neu通路的抑制剂现在在胃肠道癌症和其他实体恶性肿瘤的治疗中发挥着重要作用。在结直肠癌和胃癌中，表皮生长因子受体抑制剂和HER2/neu抑制剂的使用增加了晚期疾病患者的可用治疗选择。-关注目前胃肠道恶性肿瘤的靶向治疗和反应预测因素。数据源。-使用PubMed（美国国家医学图书馆）可检索的医学文献以及文献综述中揭示的较早的研究作为数据来源。-对这些药物靶向通路的关键要素进行基因检测（如结肠直肠癌中的KRAS突变分析和胃癌中的HER2/neu检测），可以预测哪些患者将对这些治疗产生反应。随着肿瘤的分子谱和我们对癌症基因组学和表观遗传改变的理解不断增长，预计这些个性化靶向治疗将成为胃肠道癌症治疗的主要支柱之一。（Arch Pathol Lab Med. 2012;136:496-503; doi: 10.5858/arpa.2011-0167-RA）
Context.-In recent years, there has been a tremendous amount of interest in the development of targeted therapies for the treatment of human cancers. Increased understanding of the specific molecular pathways and driver mutations critical to cancer cell growth have allowed the development of these advanced therapeutics. Among these, inhibitors of the epidermal growth factor receptor and HER2/neu pathways now play a major role in the management of gastrointestinal cancers in addition to other solid malignancies. In colorectal and gastric cancers, the use of epidermal growth factor receptor inhibitors and HER2/neu inhibitors has increased the available treatment options for patients with advanced disease.Objective.-To focus on the current targeted therapies and predictors of response in malignancies of the gastrointestinal tract.Data Sources.-Medical literature searchable on PubMed (US National Library of Medicine) as well as older studies revealed by the literature review were used as the source of data.Conclusion.-Gene testing of critical elements of the pathways targeted by these agents (such as KRAS mutational analysis in colorectal tumors and HER2/neu testing in gastric cancers) allows the ability to predict which patients will respond to these treatments. As the molecular profiling of tumors and our understanding of cancer genomics and epigenetic alterations continues to grow, it is expected that these personalized targeted therapies will form one of the mainstays of gastrointestinal cancer treatment. (Arch Pathol Lab Med. 2012;136:496-503; doi: 10.5858/arpa.2011-0167-RA)