[1]翁妍,张少玲.肾上腺皮质癌的治疗新进展[J].国际内分泌代谢杂志,2023,43(06):504-507.[doi:10.3760/cma.j.cn121383-20221024-10037]
 Weng Yan,Zhang Shaoling..Research progress of the treatment of adrenocortical carcinoma[J].International Journal of Endocrinology and Metabolism,2023,43(06):504-507.[doi:10.3760/cma.j.cn121383-20221024-10037]
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肾上腺皮质癌的治疗新进展()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
43
期数:
2023年06期
页码:
504-507
栏目:
综述
出版日期:
2023-11-20

文章信息/Info

Title:
Research progress of the treatment of adrenocortical carcinoma
作者:
翁妍张少玲
中山大学孙逸仙纪念医院内分泌科,广州 510120
Author(s):
Weng Yan Zhang Shaoling.
Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
关键词:
肾上腺皮质癌 米托坦 化学治疗 靶向及免疫治疗 基因治疗 临床试验
Keywords:
Adrenocoritical carcinoma Mitotane Chemotherapy Targeted and immunotherapy Gene therapy Clinical trials
DOI:
10.3760/cma.j.cn121383-20221024-10037
摘要:
肾上腺皮质癌(adrenocoritical carcinoma,ACC)是一种罕见、恶性度高的内分泌肿瘤,预后不良。随着研究的不断深入,针对ACC的治疗方法越来越丰富。手术是目前最有效的治疗方法,米托坦是ACC术后的主要辅助治疗用药。对于无法手术或手术不能完全切除者可考虑化疗、放疗等。另外,分子靶向治疗在ACC中可能有巨大的潜力,包括酪氨酸受体抑制剂、胰岛素样生长因子1受体抑制剂、哺乳动物雷帕霉素靶蛋白抑制剂等。近年还涌现出免疫治疗及针对基因突变相关位点的治疗方法。如何根据患者特点,选择最佳的个体化治疗方案是今后研究的重要方向之一。
Abstract:
Adrenocortical carcinoma(ACC)is a rare and highly aggressive endocrine tumor with a poor prognosis. With the research deepens, an increasing variety of treatments for ACC are available now. Surgery is currently the most effective treatment, and adjuvant mitotane therapy is the main postoperative regimen for ACC. Chemotherapy and radiotherapy are considered for those who cannot be operated or cannot be completely removed by surgery. In addition, molecular targeted therapy may have great potential in ACC, including tyrosine receptor inhibitors, insulin-like growth factor I receptor inhibitors, mTOR inhibitors, etc. Immunotherapies and treatments targeting gene mutation-associated loci have also emerged in recent years. To choose the best regimens is an important research direction for the present and the future.

参考文献/References:

[1] Fassnacht M,Assie G,Baudin E,et al.ESMO Guidelines Committee.Adrenocortical carcinomas and malignant phaeochromocytomas: ESMO-EURACAN Clinical Practice Guidelines for diagnosis,treatment and follow-up[J].Ann Oncol,2020,31(11):1476-1490.DOI:10.1016/j.annonc.2020.08.2099.
[2] Gaujoux S,Mihai R; joint working group of ESES and ENSAT.European Society of Endocrine Surgeons(ESES)and European Network for the Study of Adrenal Tumours(ENSAT)recommendations for the surgical management of adrenocortical carcinoma[J].Br J Surg,2017,104(4):358-376.DOI:10.1002/bjs.10414.
[3] Srougi V,Bancos I,Daher M,et al.Cytoreductive surgery of the primary tumor in metastatic adrenocortical carcinoma:impact on patients' survival[J].J Clin Endocrinol Metab,2022,107(4):964-971.DOI:10.1210/clinem/dgab865.
[4] Calabrese A,Basile V,Puglisi S,et al.Adjuvant mitotane therapy is beneficial in non-metastatic adrenocortical carcinoma at high risk of recurrence[J].Eur J Endocrinol,2019,180(6):387-396.DOI:10.1530/EJE-18-0923.
[5] Terzolo M,Fassnacht M.Endocrine Tumours:our experience with the management of patients with non-metastatic adrenocortical carcinoma[J].Eur J Endocrinol,2022,187(3):R27-R40.DOI:10.1530/EJE-22-0260.
[6] Terzolo M,Baudin AE,Ardito A,et al.Mitotane levels predict the outcome of patients with adrenocortical carcinoma treated adjuvantly following radical resection [J].Eur J Endocrinol,2013,169(3):263-270.DOI:10.1530/EJE-13-0242.
[7] Fassnacht M,Terzolo M,Allolio B,et al; FIRM-ACT Study Group.Combination chemotherapy in advanced adrenocortical carcinoma[J].N Engl J Med,2012,366(23):2189-2197.DOI:10.1056/NEJMoa1200966.
[8] Kimpel O,Bedrose S,Megerle F,et al.Adjuvant platinum-based chemotherapy in radically resected adrenocortical carcinoma:a cohort study [J].Br J Cancer,2021,125(9):1233-1238.DOI:10.1038/s41416-021-01513-8.
[9] Kroiss M,Megerle F,Kurlbaum M,et al.Objective response and prolonged disease control of advanced adrenocortical carcinoma with cabozantinib[J].J Clin Endocrinol Metab,2020,105(5):1461-1468.DOI:10.1210/clinem/dgz318.
[10] O'Sullivan C,Edgerly M,Velarde M,et al.The VEGF inhibitor axitinib has limited effectiveness as a therapy for adrenocortical cancer[J].J Clin Endocrinol Metab,2014,99(4):1291-1297.DOI:10.1210/jc.2013-2298.
[11] Bedrose S,Miller KC,Altameemi L,et al.Combined lenvatinib and pembrolizumab as salvage therapy in advanced adrenal cortical carcinoma[J].J Immunother Cancer,2020,8(2):e001009.DOI:10.1136/jitc-2020-001009.
[12] Fassnacht M,Berruti A,Baudin E,et al.Linsitinib(OSI-906)versus placebo for patients with locally advanced or metastatic adrenocortical carcinoma:a double-blind,randomised,phase 3 study[J].Lancet Oncol,2015,16(4):426-435.DOI:10.1016/S1470-2045(15)70081-1.
[13] Naing A,Lorusso P,Fu S,et al.Insulin growth factor receptor(IGF-1R)antibody cixutumumab combined with the mTOR inhibitor temsirolimus in patients with metastatic adrenocortical carcinoma[J].Br J Cancer,2013,108(4):826-830.DOI:10.1038/bjc.2013.46.
[14] Le Tourneau C,Hoimes C,Zarwan C,et al.Avelumab in patients with previously treated metastatic adrenocortical carcinoma:phase 1b results from the JAVELIN solid tumor trial[J].J Immunother Cancer,2018,6(1):111.DOI:10.1186/s40425-018-0424-9.
[15] Raj N,Zheng Y,Kelly V,et al.PD-1 blockade in advanced adrenocortical carcinoma[J].J Clin Oncol,2020,38(1):71-80.DOI:10.1200/JCO.19.01586.
[16] Carneiro BA,Konda B,Costa RB,et al.Nivolumab in metastatic adrenocortical carcinoma:results of a phase 2 trial[J].J Clin Endocrinol Metab,2019,104(12):6193-6200.DOI:10.1210/jc.2019-00600.
[17] Nelson DW,Chang SC,Bandera BC,et al.Adjuvant radiation is associated with improved survival for select patients with non-metastatic adrenocortical carcinoma[J].Ann Surg Oncol,2018,25(7):2060-2066.DOI:10.1245/s10434-018-6510-x.
[18] Hahner S,Hartrampf PE,Mihatsch PW,et al.Targeting 11-beta hydroxylase with [131I]IMAZA:a novel approach for the treatment of advanced adrenocortical carcinoma[J].J Clin Endocrinol Metab,2022,107(4):e1348-e1355.DOI:10.1210/clinem/dgab895.
[19] Liang R,Weigand I,Lippert J,et al.Targeted gene expression profile reveals CDK4 as therapeutic target for selected patients with adrenocortical carcinoma[J].Front Endocrinol(Lausanne),2020,11:219.DOI:10.3389/fendo.2020.00219.
[20] Thomas A,Redon CE,Sciuto L,et al.Phase I study of ATR inhibitor M6620 in combination with topotecan in patients with advanced solid tumors[J].J Clin Oncol,2018,36(16):1594-1602.DOI:10.1200/JCO.2017.76.6915.

备注/Memo

备注/Memo:
基金项目:国家自然科学基金项目(81970683); 科技部国家重点研发项目(2021YFC2501603,2021YFC2501600)
通信作者:张少玲,Email:zhshaol@mail.sysu.edu.cn
更新日期/Last Update: 2023-12-30