|
| 软组织肉瘤一线化疗失败后的应对策略与研究进展 |
| Management Strategies and Research Advances in Soft Tissue Sarcoma After Failure of First-Line Chemotherapy |
| 投稿时间：2025-04-01 修订日期：2025-11-17 |
| DOI： |
|
 |
| 中文关键词: 软组织肉瘤,化疗,靶向,免疫 |
| 英文关键词:oft tissue sarcoma, Chemotherapy, Targeted therapy, Immunotherapy |
| 基金项目: |
|
| 摘要点击次数: 220 |
| 全文下载次数: 19 |
| 中文摘要: |
| 软组织肉瘤（soft tissue sarcomas，STS）是一类罕见的间叶源性恶性肿瘤，化疗仍是最广泛的系统化治疗手段，阿霉素和异环磷酰胺为目前公认的一线化疗方案。一线化疗失败后的略策调整尤为重要，此时，应迅速对病情进行评估，根据肿瘤分子分型和生物学特性，可考虑多模式治疗策略，二线化疗仍是基础方案，常用药物包括吉西他滨、多西他赛或联合方案（如多柔比星耐药后换用达卡巴嗪联合抗血管靶向药），但需评估患者骨髓储备及既往用药毒副作用。靶向治疗为关键补充，针对特定分子异常（如PDGFR、FGFR、KIT突变或NTRK融合）选择对应抑制剂（如阿昔替尼、培唑帕尼）可提高疗效；免疫治疗（PD-1/PD-L1抑制剂）在MSI-H或高TMB亚型中显示潜力，此外，局部治疗措施，如手术、介入、放疗等应用仍有一定的价值，特别是对有限病灶的局部控制。另外，参与新的临床试验，获取潜在的新型治疗方案。未来，根据患者的基因、肿瘤分子的表型、免疫状态等因素，定制个性化方案和对不同STS亚型药物的开发与应用，将为STS患者寻找一线治疗失败后的新出路。 |
| 英文摘要: |
| Soft tissue sarcomas (STS) are a group of rare malignant tumors of mesenchymal origin. Chemotherapy remains the most widely used systemic treatment modality, with doxorubicin and ifosfamide currently recognized as the first-line chemotherapy regimens.Strategy adjustment after the failure of first-line chemotherapy is particularly important. At this point, a prompt assessment of the patient"s condition should be conducted. Based on the tumor"s molecular typing and biological characteristics, multimodal treatment strategies can be considered. Second-line chemotherapy remains the foundational approach, with commonly used drugs including gemcitabine, docetaxel, or combination regimens (such as switching to dacarbazine combined with anti-angiogenic targeted agents in cases of doxorubicin-refractory disease). However, it is necessary to assess the patient"s bone marrow reserve and toxic side effects from previous medications.Targeted therapy serves as a crucial supplement. Selecting corresponding inhibitors (e.g., axitinib, pazopanib) targeting specific molecular abnormalities (such as PDGFR, FGFR, KIT mutations, or NTRK fusions) can improve therapeutic efficacy.Immunotherapy (PD-1/PD-L1 inhibitors) has shown potential in subtypes with MSI-H (microsatellite instability-high) or high TMB (tumor mutational burden). In addition, the application of local treatment measures, such as surgery, interventional therapy, and radiotherapy, still holds certain value, especially for local control of limited lesions.Furthermore, participation in new clinical trials to access potential novel treatment regimens is also advisable. In the future, the customization of personalized regimens based on factors such as the patient"s genetic profile, tumor molecular phenotype, and immune status, along with the development and application of drugs for different soft tissue sarcoma subtypes, will provide new avenues for STS patients after first-line treatment failure. |
|
在线阅读
查看/发表评论 下载PDF阅读器 |
|
|
|