在免疫治疗和精准肿瘤时代重新定义晚期癌症的治疗前景
Redefining the Treatment Landscape of Advanced Endometrial Cancer in the Era of Immunotherapy and Precision Oncology.
摘要(中文译文)
近年来，随着分子分型和新型系统治疗的整合，晚期及复发性子宫内膜癌（EC）的治疗格局已发生显著变化。本综述总结了晚期EC的当前治疗策略，重点关注免疫治疗、靶向治疗及分子指导的治疗方法。免疫检查点抑制剂（ICIs）已成为治疗的基石，尤其是在错配修复缺陷（dMMR）/微卫星高度不稳定（MSI-H）肿瘤中，已观察到持久的临床获益。近期III期试验表明，在铂类化疗基础上加用ICIs可显著改善一线治疗的无进展生存期，尤其在dMMR疾病中更为明显，而在错配修复功能完整（pMMR）肿瘤中获益较为温和但具有临床意义。在铂类治疗后阶段，帕博利珠单抗联合仑伐替尼等方案扩大了pMMR患者的治疗选择，尽管毒性有所增加。分子谱分析的进展，包括ProMisE分型，正日益指导治疗的个体化。新兴疗法，包括PARP抑制剂以及靶向HER2和Trop-2的抗体药物偶联物，正显示出有前景的抗肿瘤活性。尽管取得了这些进展，在耐药机制、最佳治疗顺序以及MMR状态之外的预测性生物标志物方面仍存在挑战。
Abstract
The therapeutic landscape of advanced and recurrent endometrial cancer (EC) has evolved substantially in recent years due to the integration of molecular classification and novel systemic therapies. This review summarizes current treatment strategies in advanced EC, focusing on immunotherapy, targeted therapies, and molecularly guided approaches. Immune checkpoint inhibitors (ICIs) have become a cornerstone of treatment, particularly in mismatch repair-deficient (dMMR)/microsatellite instability-high (MSI-H) tumors, where durable clinical benefit has been observed. Recent phase III trials demonstrated that the addition of ICIs to platinum-based chemotherapy significantly improves progression-free survival in the first-line setting, especially in dMMR disease, with more modest but clinically meaningful benefit in mismatch repair-proficient (pMMR) tumors. In the post-platinum setting, combinations such as pembrolizumab plus lenvatinib have expanded treatment options for pMMR patients, despite increased toxicity. Advances in molecular profiling, including the ProMisE classification, are increasingly guiding treatment personalization. Emerging therapies, including PARP inhibitors and antibody-drug conjugates targeting HER2 and Trop-2, are showing promising activity. Despite these advances, challenges remain regarding resistance mechanisms, optimal treatment sequencing, and predictive biomarkers beyond MMR status.
如何引用
AMA
Martina Cassaniti, Ilaria Morelli, Anna Chiara Boschi, Simona Scodes, Giuseppe Comerci, Claudia Casanova, et al. Redefining the Treatment Landscape of Advanced Endometrial Cancer in the Era of Immunotherapy and Precision Oncology.. Cancers. 2026; doi:10.3390/cancers18111837.
APA
Martina Cassaniti, Ilaria Morelli, Anna Chiara Boschi, Simona Scodes, Giuseppe Comerci, Claudia Casanova, et al (2026). Redefining the Treatment Landscape of Advanced Endometrial Cancer in the Era of Immunotherapy and Precision Oncology.. Cancers. https://doi.org/10.3390/cancers18111837
GB/T 7714
Martina Cassaniti, Ilaria Morelli, Anna Chiara Boschi, Simona Scodes, Giuseppe Comerci, Claudia Casanova, et al. Redefining the Treatment Landscape of Advanced Endometrial Cancer in the Era of Immunotherapy and Precision Oncology.[J]. Cancers, 2026 doi:10.3390/cancers18111837.
在 PubMed增强版 阅读全文
翻译全文 · AI 文献问答 · PDF 原文下载 · 引用导出