Molecular classification and novel targets in hepatocellular carcinoma: recent advancements.

Molecular classification and novel targets in hepatocellular carcinoma: recent advancements.
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DOI:
10.1055/s-0030-1247131
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发表时间:
2010-02
影响因子:
4.2
通讯作者:
Llovet JM
Llovet JM
中科院分区:
医学2区
文献类型:
--
作者:
Hoshida Y;Toffanin S;Lachenmayer A;Villanueva A;Minguez B;Llovet JM

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肝细胞癌是世界范围内最致命的癌症之一。推进这种肿瘤分子治疗的战略决策需要对其分子分类有一个清楚的了解。研究表明,参与细胞增殖(如表皮生长因子和RAS/丝裂原激活的蛋白激酶通路)、存活(如AKT/雷帕霉素途径的机制靶点)、分化(如WNT和Hedgehog通路)和血管生成(如血管内皮生长因子和血小板衍生生长因子)的信号通路异常激活,这些信号通路存在于每个肿瘤中。对累积的基因组数据集的综合分析揭示了跨不同病因和地理位置观察到的肝细胞癌肿瘤的全球分子分类方案。这样的框架将允许系统地了解频繁共发生的分子畸变,以设计针对每一特定肿瘤亚类的治疗策略。随着越来越多的分子靶向药物的临床试验,诊断和预后生物标记物的开发将特别关注研究设计和专门用于存档固定组织的新的分析技术。微RNA异常和表观遗传学改变这类新的基因组信息将为更准确地理解疾病机制提供洞察力,并扩大发现生物标记物/治疗靶点的机会。这些努力最终将实现对肝细胞癌的个性化管理。
Hepatocellular carcinoma (HCC) is one of most lethal cancers worldwide. Strategic decisions for the advancement of molecular therapies in this neoplasm require a clear understanding of its molecular classification. Studies indicate aberrant activation of signaling pathways involved in cellular proliferation (e.g., epidermal growth factor and RAS/mitogen-activated protein kinase pathways), survival (e.g., AKT/mechanistic target of rapamycin pathway), differentiation (e.g., WNT and Hedgehog pathways), and angiogenesis (e.g., vascular endothelial growth factor and platelet-derived growth factor), which is heterogeneously presented in each tumor. Integrative analysis of accumulated genomic datasets has revealed global scheme of molecular classification of HCC tumors observed across diverse etiological factors and geographic locations. Such framework will allow systematic understanding of the frequently co-occurring molecular aberrations to design treatment strategy for each specific subclass of tumors. Accompanied with growing number of clinical trials of molecular targeted drugs, diagnostic and prognostic biomarker development will be facilitated with special attention on study design and with new assay technologies specialized for archived fixed tissues. New class of genomic information, microRNA dysregulation and epigenetic alterations, will provide insight for more precise understanding of disease mechanism and expand the opportunity of biomarker/therapeutic target discovery. These efforts will eventually enable personalized management of HCC.
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