ObjectiveTo review the recent progress of the molecular targeted therapy for thyroid cancer. MethodsThe literatures of molecular etiology for thyroid cancer, mechanism and evaluation of targeted therapy via Medline and CHKD database were reviewed. ResultsSo far, four molecular targeted drugs (Sorafenib, Lenvatinib, Vandetanib, and Cabozantinib) have been approved for treatment of advanced thyroid cancer by FDA. They can mainly improve the patient's progression-free survival. Besides, several new molecular targeted drugs have accomplishedⅠphase or Ⅱ phase clinical trials. These drugs may be new options for treatment of advanced thyroid cancer in the future. ConclusionsMolecular targeted drugs have been the main therapeutic method for advanced thyroid cancer. However, we should invent more effective new drugs and investigate the drug combination to improve the therapeutic effect.
ObjectiveTo evaluate the safety and efficacy of lenvatinib as targeted therapy for locally advanced thyroid cancer. MethodsThe data of 17 patients with locally advanced thyroid cancer who received targeted therapy in the Department of Head and Neck Surgery, Clinical Oncology School of Fujian Cancer Hospital from September 2021 to June 2023 were prospectively collected and analyzed. ResultsSeventeen patients received lenvatinib for a median of 8 weeks (4–32 weeks), 5 patients achieved partial response, 11 patients achieved stable disease, and 1 patient experienced progressive disease. The objective response and disease control rates were 29.4% (5/17) and 94.1% (16/17) respectively, the median tumor diameter of the target lesion decreased from 43 mm before treatment to 12 mm after treatment. Five patients did not undergo surgery because of tumor progression and their refusal; R0/1 resection was achieved in 11 of the 12 remaining patients (91.7%). All patients suffered from drug-related adverse events, and the commonest drug-related adverse events were hypertension (7/17, 41.2%), diarrhea (6/17, 35.3%), and proteinuria (5/17, 29.4%). There were no major drug-related adverse events. ConclusionPreliminary analysis indicates that lenvatinib is effective and safe for targeted therapy of locally advanced thyroid cancer, with a relatively high rate of R0/1 resection.
Radionuclides can be labeled on biomolecules with specific binding ability. By binding with specific targets of tumors, particles such as α or β emitted by the radionuclides will specifically irradiate tumors and produce ionizing radiation effects, resulting in cell senescence and death within the irradiation range, achieving tumor treatment results, and this way has little impact on surrounding normal tissues. Lutetium-177 (177Lu) can emit γ rays for CT imaging, and can also emit β rays for tumor treatment, so 177Lu is now one of the radionuclides that can be used for integrated diagnosis and treatment. This review summarizes the clinical application of 177Lu in several solid tumors, in conjunction with currently published research.
This study reports a case of a 56-year-old female patient with BRAF-mutated non-small cell lung cancer (NSCLC) who successfully underwent curative surgery after neoadjuvant targeted therapy with the BRAF inhibitor dabrafenib combined with the MEK inhibitor trametinib. The chest drainage tube was removed 2 days postoperatively, and the patient was discharged smoothly. Postoperative pathology indicated invasive adenocarcinoma, moderately to highly differentiated, with 80% being lepidic type, and the maximum tumor diameter was 4 cm. No vascular invasion, nerve invasion, air cavity dissemination, pleural invasion, or lymph node metastasis were observed. The postoperative staging was ypT2aN0M0. The patient continued with adjuvant treatment with dabrafenib combined with trametinib postoperatively, and no signs of recurrence were found in the follow-up examination six months after surgery.
ObjectiveTo understand the current progress of surgical treatment, radiotherapy, chemical drug therapy, endocrine therapy, targeted therapy, and immunotherapy of metaplastic breast cancer (MBC), so as to provide reference for the clinical therapy selection of MBC. MethodThe literature relevant to MBC therapy research in recent years was comprehensively reviewed. ResultsAt present, the pathogenesis of MBC was not clear. The histopathology of MBC was more complex and the prognosis was poor. Compared with the invasive ductal carcinoma, the MBC patients had older age of onset, larger tumor diameter, faster growth and stronger invasiveness. The simple mastectomy was currently used in surgical treatment. The axillary lymph node involvement rate of MBC patients was lower, so the sentinel lymph node biopsy was widely used. The chemical drug therapy, endocrine therapy, and targeted therapy had limited effects on MBC patients. However, with its unique molecular expression by the genomic analysis of MBC and rise of precision medicine, targeted therapy and immunotherapy had become current research hotspots, providing potential therapeutic strategies for MBC patients. ConclusionsDue to the complex histopathology and poor prognosis of MBC, and most research on MBC is retrospective studies, lacking sufficient prospective studies with sufficient sample size, so there is currently no clear consensus on the optimal treatment method for MBC. In order to better improve prognosis of MBC patients, further in-depth research on MBC histopathology, prospective studies with sufficient sample size, and development of targeted and effective therapeutic drugs are needed in the future.
Objective To understand breast cancer 1 (BRCA1) gene and relationship between BRCA1 gene and breast cancer, and analyze its effect on clinical comprehensive therapy of breast cancer. Method The domestic and international studies relevant BRCA1 and breast cancer in recent years were reviewed and summarized. Results BRCA1, a tumor suppressor gene, its mutations caused structural changes and functional abnormalities, which were closely related to breast cancer. And the expression situation and mutation of BRCA1 were associated with the therapeutic effect. Conclusions Mutation of BRCA1 is closely related to occurrence and development of breast cancer in female. Comprehensive therapy ideas should be found in clinical therapy according to expression or mutation of BRCA1. Further research on BTCA1 is beneficial to explore gold standard for treatment of breast cancer.
【摘要】 目的 探讨肺动脉高压患者药物靶向治疗的效果与耐受性。 方法 回顾分析2008年1月〖CD3/5〗2009年8月期间8例肺动脉高压患者分别接受波生坦及西地那非治疗的临床资料,评估其临床表现、WHO肺动脉高压功能分级、6 min步行距离及肺动脉收缩压在基线及治疗3个月后的变化。 结果 治疗后3个月,患者均能耐受药物治疗,无严重不良反应发生。WHO肺动脉高压功能分级在治疗前平均(31±04),治疗后为(23±09),明显得到改善(Plt;005)。肺动脉收缩压在治疗前平均(695±112 ) mm Hg(1 mm Hg=0133 kPa),治疗后为(483±124) mm Hg,明显降低(Plt;005)。6 min步行距离在治疗前平均(324±48) m,治疗后为(400±43) m,明显延长(Plt;005)。 结论 肺动脉高压患者药物靶向治疗的疗效显著,且耐受良好。【Abstract】 Objective To examine the effects of target medical therapy in patients with pulmonary arterial hypertension(PAH). Methods To determine the safety and efficacy of bosentan and sildenafil in eight patients with PAH.The patients’ clinical features, six minutes walking diastance, WHO functional class and systolic pulmonary arterial pressure (SPAP) were measured at baseline and at three months after initiating target medial treatment. Results At the three months followup assessments, WHO functional class was improved with 31±04 vs 23±09 (Plt;005); SPAP was significantly decreased with(695±112 ) mm Hg vs (483±124) mm Hg (Plt;005), the six minutes walking distance was significantly increased with(324±48) m vs(400±43) m (Plt;005). Target medical treatment was well tolerated. Conclusion Target medical treatment is well tolerated and has beneficial effects on PAH.
High-grade gliomas are the most common malignant primary central nervous system tumors with poor prognosis. The operation based on the principle of maximum safe resection of tumors, combined with radiation therapy and chemotherapy, is the primary treatment method. This treatment only delays the progression of high-grade gliomas, and almost all patients eventually develop disease progression or relapse. With the development of molecular biology, immunology, and genomics, people have a deeper understanding of the pathogenesis of gliomas. Targeted therapy, immunotherapy, and other comprehensive treatments are expected to become potential treatments for high-grade gliomas. This article reviews the current status of medical treatment of primary and recurrent high-grade gliomas, and the research progress of high-grade gliomas in targeted therapy and immunotherapy.