摘要
原发灶不明肿瘤是经充分检查和评估后无法明确原发灶的转移性肿瘤。原发灶不明肿瘤因起源组织不明,以经验性化疗作为主要治疗方式,中位生存时间<1年。基于基因表达谱的检测方法较免疫组织化学提高了肿瘤起源组织检出的灵敏度和特异度,但对治疗的指导价值尚存在争议。免疫检查点抑制剂和泛癌种抗肿瘤药物的获批改善了原发灶不明肿瘤患者的预后,基于分子生物学检测指导下的靶向治疗和免疫治疗是未来研究的主要方向。因原发灶不明肿瘤高度的异质性和独特的临床病理特征,篮式试验更加适合应用于原发灶不明肿瘤患者的临床试验设计。
Carcinoma of unknown primary(CUP)is a kind of metastatic tumor whose primary origin cannot be identified after adequate examination and evaluation.The main treatment modality of CUP is empiric chemotherapy,and the median overall survival time is less than 1 year.Compared with immunohistochemistry,novel method based on gene expression profiling have improved the sensitivity and specificity of CUP detection,but its guiding value for treatment is still controversial.The approval of immune checkpoint inhibitors and pan-cancer antitumor agents has improved the prognosis of patients with CUP,and targeted therapy and immunotherapy based on specific molecular characteristics are the main directions of future research.Given the high heterogeneity and unique clinicopathological characteristics of CUP,"basket trial"is more suitable for clinical trial design in CUP.
作者
黎立喜
张娣
马飞
Li Lixi;Zhang Di;Ma Fei(Department of Medical Oncology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2023年第1期44-49,共6页
Chinese Journal of Oncology
关键词
原发灶不明肿瘤
预后不良亚型
化疗
靶向治疗
免疫治疗
篮式试验
Carcinoma of unknown primary
Poor prognosis subtype
Chemotherapy
Targeted therapy
Immunotherapy
Basket trial
