BRCA引导下治疗癌症

IF 0.5 4区 医学 Q4 OBSTETRICS & GYNECOLOGY European journal of gynaecological oncology Pub Date : 2021-06-15 DOI:10.31083/J.EJGO.2021.03.2210
P. Economopoulou, I. Kotsantis, A. Bamias
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引用次数: 0

摘要

晚期(FIGO III期和IV期)癌症上皮癌(aEOC)占西方国家妇科癌症死亡的大多数。尽管这种疾病的预后在过去二十年中得到了显著改善,但大多数女性仍将死于EOC的进展。最佳的细胞还原手术和细胞毒性化疗仍然是一线治疗的主要手段。大约18%的EOC具有肿瘤抑制基因乳腺癌症易感性基因1(BRCA1)和2(BRCA2)的种系突变,而另外3-6%的肿瘤具有这些基因的体细胞突变。这些突变会增加患多种癌症的易感性。此外,BRCA1和BRCA2基因编码与同源重组(HR)机制有关的蛋白质,该机制负责修复DNA双链断裂(DSBs),这是化疗的常见作用机制。在晚期EOC的治疗算法中加入BRCA靶向治疗,如聚ADP核糖聚合酶(PARP)抑制剂,进一步改善了疗效,并代表了EOC个性化治疗的成功策略。在这篇综述中,我们总结了目前对EOC和BRCA1/2突变患者的治疗建议。
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BRCA-guided therapy of ovarian cancer
Advanced (FIGO stages III and IV) epithelial ovarian cancer (aEOC) accounts for the majority of deaths from gynecological cancers in western countries. Although the prognosis of this disease has been considerably improved in the last two decades, the majority of women will still die from progression of EOC. Optimal cytoreductive surgery and cytotoxic chemotherapy remains the mainstay of treatment in the front-line setting. Approximately 18% of EOCs harbor germline mutations of the tumor suppressor genes Breast Cancer Susceptibility Gene 1 (BRCA1) and 2 (BRCA2), while another 3–6% of these tumors have somatic mutations of these genes. These mutations lead to increased predisposition of multiple cancers. In addition, BRCA1 and BRCA2 genes encode proteins that are implicated in the Homologous Recombination (HR) mechanism, which is responsible for the repair of DNA Double Strand Breaks (DSBs), which is a common mechanism of action of chemotherapy. The incorporation of BRCA-targeted therapies, such as poly ADP ribose polymerase (PARP) inhibitors in the treatment algorithm of advanced EOC has further improved outcomes and represents a successful strategy of individualization of treatment in EOC. In this review, we summarize current treatment recommendations for patients with EOC and a BRCA1/2 mutation.
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来源期刊
自引率
25.00%
发文量
58
审稿时长
1 months
期刊介绍: EJGO is dedicated to publishing editorial articles in the Distinguished Expert Series and original research papers, case reports, letters to the Editor, book reviews, and newsletters. The Journal was founded in 1980 the second gynaecologic oncology hyperspecialization Journal in the world. Its aim is the diffusion of scientific, clinical and practical progress, and knowledge in female neoplastic diseases in an interdisciplinary approach among gynaecologists, oncologists, radiotherapists, surgeons, chemotherapists, pathologists, epidemiologists, and so on.
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