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Evolving strategies for addressing CAR T-cell toxicities. 解决 CAR T 细胞毒性问题的策略不断发展。
IF 7.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-12-15 DOI: 10.1007/s10555-024-10227-1
Alexander W Rankin, Brynn B Duncan, Cecily Allen, Sara K Silbert, Nirali N Shah

The field of chimeric antigen receptor (CAR) T-cell therapy has grown from a fully experimental concept to now boasting a multitude of treatments including six FDA-approved products targeting various hematologic malignancies. Yet, along with their efficacy, these therapies come with side effects requiring timely and thoughtful interventions. In this review, we discuss the most common toxicities associated with CAR T-cells to date, highlighting risk factors, prognostication, implications for critical care management, patient experience optimization, and ongoing work in the field of toxicity mitigation. Understanding the current state of the field and standards of practice is critical in order to improve and manage potential toxicities of both current and novel CAR T-cell therapies as they are applied in the clinic.

嵌合抗原受体(CAR) t细胞治疗领域已经从一个完全实验性的概念发展到现在拥有多种治疗方法,包括6种fda批准的针对各种血液恶性肿瘤的产品。然而,这些疗法在产生疗效的同时,也带来了副作用,需要及时和深思熟虑的干预。在这篇综述中,我们讨论了迄今为止与CAR - t细胞相关的最常见毒性,强调了危险因素、预后、对重症监护管理的影响、患者体验优化以及在毒性缓解领域正在进行的工作。了解该领域的现状和实践标准对于改善和管理当前和新型CAR - t细胞疗法在临床应用时的潜在毒性至关重要。
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引用次数: 0
TRIM-endous functional network of tripartite motif 29 (TRIM29) in cancer progression and beyond. trim3 - motif 29 (TRIM29)在癌症进展及其后的内源功能网络。
IF 7.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-12-07 DOI: 10.1007/s10555-024-10226-2
Qitong Wu, Deeptashree Nandi, Dipali Sharma

While most Tripartite motif (TRIM) family proteins are E3 ubiquitin ligases, some members have functions beyond the regulation of ubiquitination, impacting normal physiological processes and disease progression. TRIM29, an important member of the TRIM family, exerts a predominant influence on cancer growth, epithelial-to-mesenchymal transition, stemness and metastatic progression by directly potentiating multiple canonical oncogenic pathways. The cancer-promoting effect of TRIM29 is also evident in metabolic interventions and interference with the efficacy of cancer therapeutics. As expected for any key node in cancer, the expression of TRIM29 is tightly regulated by non-coding RNAs, epigenetic modulation, and post-translational regulation. A systematic discussion of how TRIM29 is regulated in cancer, its influences on cancer progression, and its impact on cancer therapeutics is presented in this review. We also explore the context-dependent alterations between TRIM29 function from oncogenic to tumor suppression. As TRIM29 is involved in multiple aspects of cancer progression, a better understanding of its biological impact in cancer may help improve prognosis and develop novel therapeutic combinations, leading to improved personalized cancer care.

虽然大多数TRIM家族蛋白是E3泛素连接酶,但一些成员的功能超出了泛素化的调节,影响正常的生理过程和疾病进展。TRIM29是TRIM家族的重要成员,通过直接增强多种典型的致癌途径,对肿瘤生长、上皮-间质转化、干性和转移进展发挥重要影响。TRIM29的促癌作用在代谢干预和干扰癌症治疗药物的疗效方面也很明显。正如预期的那样,TRIM29的表达受到非编码rna、表观遗传调控和翻译后调控的严格调控。本文系统地讨论了TRIM29在癌症中的调控机制、对癌症进展的影响以及对癌症治疗的影响。我们还探讨了TRIM29功能从致癌到肿瘤抑制之间的环境依赖性改变。由于TRIM29参与癌症进展的多个方面,更好地了解其在癌症中的生物学影响可能有助于改善预后和开发新的治疗组合,从而改善个性化的癌症治疗。
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引用次数: 0
Correlative studies reveal factors contributing to successful CAR-T cell therapies in cancer. 相关研究揭示了CAR-T细胞治疗癌症成功的因素。
IF 7.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-12-03 DOI: 10.1007/s10555-024-10232-4
Catherine D Yao, Kara L Davis

Cellular and targeted immunotherapies have revolutionized cancer treatments in the last several decades. Successful cellular therapies require both effective and durable cytotoxic activity from the immune cells as well as an accessible and susceptible response from targeted cancer cells. Correlative studies from clinical trials as well as real-world data from FDA-approved therapies have revealed invaluable insights about immune cell factors and cancer cell factors that impact rates of response and relapse to cellular therapies. This review focuses on the flagship cellular therapy of engineered chimeric antigen receptor T-cells (CAR-T cells). Within the CAR-T cell compartment, we discuss discoveries about T-cell phenotype, transcriptome, epigenetics, cytokine signaling, and metabolism that inform the cell manufacturing process to produce the most effective and durable CAR-T cells. Within the cancer cell compartment, we discuss mechanisms of resistance and relapse caused by mutations, alternative splicing, post-transcriptional modifications, and cellular reprogramming. Continued correlative and mechanistic studies are required to help us further optimize cellular therapies in a variety of malignancies.

在过去的几十年里,细胞和靶向免疫疗法已经彻底改变了癌症治疗。成功的细胞治疗既需要免疫细胞的有效和持久的细胞毒性活性,也需要靶向癌细胞的可及和易感反应。来自临床试验的相关研究以及fda批准的治疗方法的实际数据揭示了影响细胞治疗反应率和复发率的免疫细胞因子和癌细胞因子的宝贵见解。本文综述了工程化嵌合抗原受体t细胞(CAR-T细胞)的主要细胞治疗方法。在CAR-T细胞区室中,我们讨论了关于t细胞表型、转录组、表观遗传学、细胞因子信号传导和代谢的发现,这些发现为细胞制造过程提供了信息,以产生最有效和最持久的CAR-T细胞。在癌细胞区室中,我们讨论了由突变、选择性剪接、转录后修饰和细胞重编程引起的耐药和复发机制。需要持续的相关和机制研究来帮助我们进一步优化各种恶性肿瘤的细胞治疗。
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引用次数: 0
CAR T-cell therapy to treat multiple myeloma: current state and future directions. CAR - t细胞疗法治疗多发性骨髓瘤:现状与未来方向
IF 7.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-12-03 DOI: 10.1007/s10555-024-10219-1
Siddhartha Thammineni Reddy, Hitomi Hosoya, Lekha Mikkilineni

Chimeric antigen receptor (CAR) T-cell therapy represents a transformative advancement in treating relapsed or refractory multiple myeloma (MM) in both early- and late-line settings. MM, a plasma cell malignancy, traditionally requires ongoing complex drug regimens, posing significant burdens on patients. In contrast, CAR T-cell therapy offers a one-time treatment option without the need for continuous maintenance therapy. CAR T-cell therapy leverages engineered T-cells to target specific antigens on tumor cells, leading to their elimination. Current approved therapies target B-cell maturation antigen (BCMA); new targets are under investigation, such as G-protein-coupled receptor class C group 5 member D (GPRC5D). Despite its efficacy, CAR T-cell therapy is associated with serious toxicities such as cytokine release syndrome (CRS) and immune-effector cell-associated neurotoxicity syndrome (ICANS), necessitating careful management. The review will provide an overview of the design and manufacturing of CAR T-cells and current FDA indications, as well as challenges and future directions of CAR-T therapy for MM treatment.

嵌合抗原受体(CAR) t细胞疗法代表了早期和晚期治疗复发或难治性多发性骨髓瘤(MM)的变革性进展。MM是一种浆细胞恶性肿瘤,传统上需要持续复杂的药物治疗方案,给患者带来了巨大的负担。相比之下,CAR -t细胞疗法提供了一次性的治疗选择,而不需要持续的维持治疗。CAR - t细胞疗法利用工程化的t细胞靶向肿瘤细胞上的特定抗原,从而消除肿瘤细胞。目前批准的疗法针对b细胞成熟抗原(BCMA);新的靶点正在研究中,如g蛋白偶联受体C类第5组成员D (GPRC5D)。尽管有疗效,但CAR - t细胞疗法与严重的毒性相关,如细胞因子释放综合征(CRS)和免疫效应细胞相关神经毒性综合征(ICANS),需要仔细管理。该综述将概述CAR- t细胞的设计和制造以及目前FDA的适应症,以及CAR- t治疗MM的挑战和未来方向。
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引用次数: 0
Ribosomal rodeo: wrangling translational machinery in gynecologic tumors. 核糖体竞技:妇科肿瘤的角力翻译机制。
IF 7.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-12-02 DOI: 10.1007/s10555-024-10234-2
Kamil Filipek, Marianna Penzo

Gynecologic cancers are a significant cause of morbidity and mortality among women worldwide. Despite advancements in diagnosis and treatment, the molecular mechanisms underlying the development and progression of these cancers remain poorly understood. Recent studies have implicated translational machinery (ribosomal proteins (RPs) and translation factors (TFs)) as potential drivers of oncogenic processes in various cancer types, including gynecologic cancers. RPs are essential components of the ribosome, which is responsible for protein synthesis. In this review paper, we aim to explore the role of translational machinery in gynecologic cancers. Specifically, we will investigate the potential mechanisms by which these components contribute to the oncogenic processes in these cancers and evaluate the feasibility of targeting RPs as a potential therapeutic strategy. By doing so, we hope to provide a broader view of the molecular pathogenesis of gynecologic cancers and highlight their potential as novel therapeutic targets for the management of these challenging diseases.

妇科癌症是全世界妇女发病和死亡的一个重要原因。尽管在诊断和治疗方面取得了进步,但这些癌症发生和发展的分子机制仍然知之甚少。最近的研究表明,翻译机制(核糖体蛋白(RPs)和翻译因子(TFs))是多种癌症(包括妇科癌症)致癌过程的潜在驱动因素。核糖核酸是核糖体的重要组成部分,核糖体负责蛋白质合成。在这篇综述文章中,我们旨在探讨翻译机制在妇科癌症中的作用。具体来说,我们将研究这些成分在这些癌症中致癌过程中的潜在机制,并评估靶向rp作为潜在治疗策略的可行性。通过这样做,我们希望为妇科癌症的分子发病机制提供更广阔的视野,并强调它们作为这些具有挑战性疾病管理的新治疗靶点的潜力。
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引用次数: 0
Tumor necrosis factor superfamily signaling: life and death in cancer. 肿瘤坏死因子超家族信号传导:癌症中的生与死。
IF 4.4 2区 医学 Q1 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-10-04 DOI: 10.1007/s10555-024-10206-6
Obada Ababneh, Daisuke Nishizaki, Shumei Kato, Razelle Kurzrock

Immune checkpoint inhibitors have shaped the landscape of cancer treatment. However, many patients either do not respond or suffer from later progression. Numerous proteins can control immune system activity, including multiple tumor necrosis factor (TNF) superfamily (TNFSF) and TNF receptor superfamily (TNFRSF) members; these proteins play a complex role in regulating cell survival and death, cellular differentiation, and immune system activity. Notably, TNFSF/TNFRSF molecules may display either pro-tumoral or anti-tumoral activity, or even both, depending on tumor type. Therefore, TNF is a prototype of an enigmatic two-faced mediator in oncogenesis. To date, multiple anti-TNF agents have been approved and/or included in guidelines for treating autoimmune disorders and immune-related toxicities after immune checkpoint blockade for cancer. A confirmed role for the TNFSF/TNFRSF members in treating cancer has proven more elusive. In this review, we highlight the cancer-relevant TNFSF/TNFRSF family members, focusing on the death domain-containing and co-stimulation members and their signaling pathways, as well as their complicated role in the life and death of cancer cells.

免疫检查点抑制剂改变了癌症治疗的格局。然而,许多患者要么没有反应,要么病情恶化。许多蛋白质可以控制免疫系统的活动,包括多种肿瘤坏死因子(TNFSF)超家族(TNFSF)和TNF受体超家族(TNFRSF)成员;这些蛋白质在调节细胞存活和死亡、细胞分化和免疫系统活动方面发挥着复杂的作用。值得注意的是,根据肿瘤类型的不同,TNFSF/TNFRSF 分子既可能具有促肿瘤活性,也可能具有抗肿瘤活性,甚至两者兼而有之。因此,TNF 是肿瘤发生过程中神秘的双面介质的原型。迄今为止,多种抗 TNF 药物已被批准和/或纳入指南,用于治疗自身免疫性疾病和免疫检查点阻断治疗癌症后的免疫相关毒性。事实证明,TNFSF/TNFRSF 成员在治疗癌症中的作用尚未得到证实。在这篇综述中,我们将重点介绍与癌症相关的 TNFSF/TNFRSF 家族成员,重点是含死亡结构域和协同刺激成员及其信号通路,以及它们在癌细胞生死过程中的复杂作用。
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引用次数: 0
The roles of PD-L1 in the various stages of tumor metastasis. PD-L1 在肿瘤转移各阶段中的作用。
IF 7.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-05-11 DOI: 10.1007/s10555-024-10189-4
Yinjun He, Ming Zhu, Xuan Lai, Honghe Zhang, Weiqin Jiang

The interaction between tumor programmed death ligand 1 (PD-L1) and T-cell programmed cell death 1 (PD-1) has long been acknowledged as a mechanism for evading immune surveillance. Recent studies, however, have unveiled a more nuanced role of tumor-intrinsic PD-L1 in reprograming tumoral phenotypes. Preclinical models emphasize the synchronized effects of both intracellular and extracellular PD-L1 in promoting metastasis, with intricate interactions with the immune system. This review aims to summarize recent findings to elucidate the spatiotemporal heterogeneity of PD-L1 expression and the pro-metastatic roles of PD-L1 in the entire process of tumor metastasis. For example, PD-L1 regulates the epithelial-to-mesenchymal transition (EMT) process, facilitates the survival of circulating tumor cells, and induces the formation of immunosuppressive environments at pre-metastatic niches and metastatic sites. And the complexed and dynamic regulation process of PD-L1 for tumor metastasis is related to the spatiotemporal heterogeneity of PD-L1 expression and functions from tumor primary sites to various metastatic sites. This review extends the current understandings for the roles of PD-L1 in mediating tumor metastasis and provides new insights into therapeutic decisions in clinical practice.

肿瘤程序性死亡配体1(PD-L1)与T细胞程序性细胞死亡1(PD-1)之间的相互作用一直被认为是逃避免疫监视的一种机制。然而,最近的研究揭示了肿瘤内源性 PD-L1 在重编程肿瘤表型中更微妙的作用。临床前模型强调了细胞内和细胞外 PD-L1 在促进转移方面的同步作用,以及与免疫系统之间错综复杂的相互作用。本综述旨在总结最近的研究结果,以阐明 PD-L1 表达的时空异质性以及 PD-L1 在肿瘤转移全过程中的促转移作用。例如,PD-L1调控上皮细胞向间质转化(EMT)过程,促进循环肿瘤细胞的存活,诱导转移前壁龛和转移部位形成免疫抑制环境。而 PD-L1 对肿瘤转移的复杂动态调控过程与 PD-L1 从肿瘤原发部位到不同转移部位的表达和功能的时空异质性有关。本综述扩展了目前对 PD-L1 在介导肿瘤转移中作用的认识,并为临床实践中的治疗决策提供了新的见解。
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引用次数: 0
Healthcare disparities, screening, and molecular testing in the changing landscape of non-small cell lung cancer in the United States: a review. 美国非小细胞肺癌变化中的医疗差距、筛查和分子检测:综述。
IF 4.4 2区 医学 Q1 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-05-16 DOI: 10.1007/s10555-024-10187-6
Razelle Kurzrock, Aadel A Chaudhuri, David Feller-Kopman, Narjust Florez, Jed Gorden, Ignacio I Wistuba

Inequitable access to care continues to hinder improvements in diagnosis and treatment of lung cancer. This review describes healthcare disparities in the changing landscape of non-small cell lung cancer (NSCLC) in the United States, focusing on racial, ethnic, sex-based, and socioeconomic trends. Furthermore, strategies to address disparities, overcome challenges, and improve patient outcomes are proposed. Barriers exist across lung cancer screening, diagnosis, and treatment regimens, varying by sex, age, race and ethnicity, geography, and socioeconomic status. Incidence and mortality rates of lung cancer are higher among Black men than White men, and incidences in young women are substantially greater than in young men. Disparities may be attributed to geographic differences in screening access, with correlating higher incidence and mortality rates in rural versus urban areas. Lower socioeconomic status is also linked to lower survival rates. Several strategies could help reduce disparities and improve outcomes. Current guidelines could improve screening eligibility by incorporating sex, race, and socioeconomic status variables. Patient and clinician education on screening guidelines and patient-level barriers to care are key, and biomarker testing is critical since ~ 70% of patients with NSCLC have an actionable biomarker. Timely diagnosis, staging, and comprehensive biomarker testing, including cell-free DNA liquid biopsy, may provide valuable treatment guidance for patients with NSCLC. Efforts to improve lung cancer screening and biomarker testing access, decrease bias, and improve education about screening and testing are needed to reduce healthcare disparities in NSCLC.

医疗服务的不公平继续阻碍着肺癌诊断和治疗的改善。这篇综述描述了美国非小细胞肺癌(NSCLC)不断变化的医疗差距,重点关注种族、民族、性别和社会经济趋势。此外,还提出了应对差异、克服挑战和改善患者预后的策略。肺癌筛查、诊断和治疗方案都存在障碍,因性别、年龄、种族和民族、地域以及社会经济状况而异。黑人男性的肺癌发病率和死亡率高于白人男性,年轻女性的发病率也远高于年轻男性。造成差异的原因可能是筛查机会的地域差异,农村地区的发病率和死亡率高于城市地区。较低的社会经济地位也与较低的存活率有关。有几种策略有助于减少差异和改善结果。现行指南可通过纳入性别、种族和社会经济地位变量来提高筛查资格。对患者和临床医生进行筛查指南和患者护理障碍方面的教育是关键所在,生物标志物检测也至关重要,因为约 70% 的 NSCLC 患者有可操作的生物标志物。及时诊断、分期和全面的生物标志物检测(包括无细胞 DNA 液体活检)可为 NSCLC 患者提供有价值的治疗指导。要减少 NSCLC 患者的医疗差距,就必须努力改善肺癌筛查和生物标志物检测的可及性,减少偏见,并加强有关筛查和检测的教育。
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引用次数: 0
Mechanical deformation and death of circulating tumor cells in the bloodstream. 血液中循环肿瘤细胞的机械变形和死亡。
IF 7.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-07-09 DOI: 10.1007/s10555-024-10198-3
Yunxiu Qiu, Tong Gao, Bryan Ronain Smith

The circulation of tumor cells through the bloodstream is a significant step in tumor metastasis. To better understand the metastatic process, circulating tumor cell (CTC) survival in the circulation must be explored. While immune interactions with CTCs in recent decades have been examined, research has yet to sufficiently explain some CTC behaviors in blood flow. Studies related to CTC mechanical responses in the bloodstream have recently been conducted to further study conditions under which CTCs might die. While experimental methods can assess the mechanical properties and death of CTCs, increasingly sophisticated computational models are being built to simulate the blood flow and CTC mechanical deformation under fluid shear stresses (FSS) in the bloodstream.Several factors contribute to the mechanical deformation and death of CTCs as they circulate. While FSS can damage CTC structure, diverse interactions between CTCs and blood components may either promote or hinder the next metastatic step-extravasation at a remote site. Overall understanding of how these factors influence the deformation and death of CTCs could serve as a basis for future experiments and simulations, enabling researchers to predict CTC death more accurately. Ultimately, these efforts can lead to improved metastasis-specific therapeutics and diagnostics specific in the future.

肿瘤细胞通过血液循环是肿瘤转移的一个重要步骤。为了更好地了解转移过程,必须探索循环肿瘤细胞(CTC)在血液循环中的生存情况。近几十年来,人们对免疫与 CTC 的相互作用进行了研究,但还没有充分解释 CTC 在血流中的某些行为。最近开展了与血液中 CTC 机械反应有关的研究,以进一步研究 CTC 可能死亡的条件。虽然实验方法可以评估 CTC 的机械特性和死亡情况,但目前正在建立越来越复杂的计算模型,以模拟血流和 CTC 在血液中流体剪切应力(FSS)作用下的机械变形。虽然流体剪切应力会破坏 CTC 的结构,但 CTC 与血液成分之间的各种相互作用可能会促进或阻碍下一个转移步骤--向远处扩散。全面了解这些因素如何影响 CTC 的变形和死亡,可作为未来实验和模拟的基础,使研究人员能更准确地预测 CTC 的死亡。最终,这些努力将在未来改进转移特异性治疗和诊断方法。
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引用次数: 0
Advances in the molecular biology of the solitary fibrous tumor and potential impact on clinical applications. 单发纤维瘤分子生物学研究进展及对临床应用的潜在影响。
IF 4.4 2区 医学 Q1 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-09 DOI: 10.1007/s10555-024-10204-8
Chongmin Ren, Gina D'Amato, Francis J Hornicek, Hao Tao, Zhenfeng Duan

Solitary fibrous tumor (SFT) is a rare fibroblastic mesenchymal neoplasm. The current classification has merged SFT and hemangiopericytoma (HPC) into the same tumor entity, while the risk stratification models have been developed to compensate for clinical prediction. Typically, slow-growing and asymptomatic, SFT can occur in various anatomical sites, most commonly in the pleura. Histologically, SFT consists of spindle to oval cells with minimal patterned growth, surrounded by stromal collagen and unique vascular patterns. Molecularly, SFT is defined by the fusion of NGFI-A-binding protein 2 (NAB2) and signal transducer and activator of transcription 6 (STAT6) genes as NAB2-STAT6. This fusion transforms NAB2 into a transcriptional activator, activating early growth response 1 (EGR1) and contributing to SFT pathogenesis and development. There are several fusion variants of NAB2-STAT6 in tumor tissues, with the most frequent ones being NAB2ex4-STAT6ex2 and NAB2ex6-STAT6ex16/ex17. Diagnostic methods play a crucial role in SFT clinical practice and basic research, including RT-PCR, next-generation sequencing (NGS), FISH, immunohistochemistry (IHC), and Western blot analysis, each with distinct capabilities and limitations. Traditional treatment strategies of SFT encompass surgical resection, radiation therapy, and chemotherapy, while emerging management regimes include antiangiogenic agents, immunotherapy, RNA-targeting technologies, and potential targeted drugs. This review provides an update on SFT's clinical and molecular aspects, diagnostic methods, and potential therapies.

孤立性纤维瘤(SFT)是一种罕见的成纤维间质肿瘤。目前的分类方法已将 SFT 和血管扩张性细胞瘤(HPC)合并为同一肿瘤实体,而风险分层模型的开发则是为了弥补临床预测的不足。SFT通常生长缓慢且无症状,可发生在不同的解剖部位,最常见于胸膜。从组织学角度看,SFT 由纺锤形至椭圆形细胞组成,具有最小的生长模式,周围有基质胶原和独特的血管模式。分子上,SFT 是由 NGFI-A 结合蛋白 2(NAB2)和信号转导及激活转录 6(STAT6)基因融合而成,即 NAB2-STAT6。这种融合将 NAB2 转化为转录激活因子,激活早期生长应答 1(EGR1),并促进 SFT 的发病和发育。肿瘤组织中存在多种 NAB2-STAT6 融合变体,其中最常见的是 NAB2ex4-STAT6ex2 和 NAB2ex6-STAT6ex16/ex17。诊断方法在 SFT 临床实践和基础研究中发挥着重要作用,包括 RT-PCR、新一代测序(NGS)、FISH、免疫组织化学(IHC)和 Western 印迹分析,每种方法都有其独特的功能和局限性。SFT 的传统治疗策略包括手术切除、放疗和化疗,而新兴的治疗方案包括抗血管生成药物、免疫疗法、RNA 靶向技术和潜在的靶向药物。本综述提供了有关 SFT 临床和分子方面、诊断方法和潜在疗法的最新信息。
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引用次数: 0
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