标准疗法和额外的放射性碘(131I)疗法;哪一种疗法能阻止多形性胶质母细胞瘤(GBM)复发?

Endokrynologia Polska Pub Date : 2024-01-01 Epub Date: 2024-04-22 DOI:10.5603/ep.98240
Agata Czarnywojtek, Paweł Gut, Kamil Dyrka, Jerzy Sowiński, Nadia Sawicka-Gutaj, Katarzyna Katulska, Piotr Stajgis, Mateusz Wykrętowicz, Jakub Moskal, Jeremi Kościński, Krzysztof Pietrończyk, Patryk Graczyk, Maciej Robert Krawczyński, Ewa Florek, Ewelina Szczepanek-Parulska, Marek Ruchała, Alfio Ferlito
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引用次数: 0

摘要

多形性胶质母细胞瘤(GBM)是侵袭性最强的恶性脑肿瘤。采用标准治疗方法,确诊为多形性胶质母细胞瘤的患者平均存活时间为几个月。文章作者提出了一个直接的问题:在不使用碘化钠合剂(NIS)基因的情况下,是否有可能只用放射性碘(¹³¹I)治疗 GBM?毕竟,NIS 不仅在甲状腺中被检测到,在各种肿瘤中也被检测到。本文主要作者(A.C.)在其同事(医生和药理学家)的协助下,在进行碘抑制后接受了¹³¹I治疗,结果磁共振成像(MRI)显示肿瘤缩小了约30%。GBM的传统疗法包括神经外科手术、传统放疗和化疗(如替莫唑胺)。目前正在使用酪氨酸激酶抑制剂(伊马替尼、舒尼替尼和索拉非尼)。此外,克唑替尼、恩替替尼或拉罗替尼等新型药物也在应用中。最近,随着细胞和分子免疫学的发展,基于溶瘤病毒抗肿瘤疫苗的个性化多模式免疫疗法(IMI)也得到了开发。因此,¹³¹I疗法首次成功应用于GBM复发病例。
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Standard therapy or additionally radioactive iodine (131I) therapy; which will stop the recurrence of glioblastoma multiforme (GBM)?

Glioblastoma multiforme (GBM) is the most aggressive malignant brain tumour. The average survival time for a patient diagnosed with GBM, using standard treatment methods, is several months. Authors of the article pose a direct question: Is it possible to treat GBM solely with radioactive iodine (¹³¹I) therapy without employing the sodium iodide symporter (NIS) gene? After all, NIS has been detected not only in the thyroid but also in various tumours. The main author of this article (A.C.), with the assistance of her colleagues (physicians and pharmacologists), underwent ¹³¹I therapy after prior iodine inhibition, resulting in approximately 30% reduction in tumour size as revealed by magnetic resonance imaging (MRI). Classical therapy for GBM encompasses neurosurgery, conventional radiotherapy, and chemotherapy (e.g. temozolomide). Currently, tyrosine kinase inhibitors (imatinib, sunitinib, and sorafenib) are being used. Additionally, novel drugs such as crizotinib, entrectinib, or larotrectinib are being applied. Recently, personalised multimodal immunotherapy (IMI) based on anti-tumour vaccines derived from oncolytic viruses has been developed, concomitant with the advancement of cellular and molecular immunology. Thus, ¹³¹I therapy has been successfully employed for the first time in the case of GBM recurrence.

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