晚期骨肉瘤抗血管生成靶向治疗的研究进展

Progress of anti-angiogenesis targeted therapy of advanced osteosarcoma

骨肉瘤是一种间质起源的原发性骨恶性肿瘤,发病人群较年轻,肿瘤的恶性程度高、预后差,同时易复发和转移,治疗较为困难。骨肉瘤血运丰富,其生长、侵袭、浸润、转移均依赖于肿瘤新生血管形成,血管生成主要由肿瘤细胞分泌的各种促血管生成因子始动,根据各种促血管生成因子的作用靶点及信号通路采取抗血管生成靶向治疗,能够有效抑制骨肉瘤的各种生物学行为,提高患者的生存率。但抗血管生成治疗过程中也存在耐药、不良反应较大、疗效评估标准不一、治疗策略难以选择等问题,需要进一步研究解决。文章主要对骨肉瘤抗血管生成药物的临床研究、存在的问题及治疗策略等内容进行综述。

Osteosarcoma is a malignant tumor of mesenchymal origin and occurs mostly in young people, which is characterized with high malignancy, poor prognosis, easy recurrence and metastasis, as well as a great difficulty in treatment. Osteosarcoma is rich in blood supply, and its growth, invasion and metastasis highly depend on the tumor new angiogenesis. The process of angiogenesis is mainly initiated by various pro-angiogenic factors secreted by tumor cells, and the anti-angiogenic targeted therapy has been taken based on the targets spot and signal pathways of various angiogenic factors, which can effectively suppress the various biological behaviors of the osteosarcoma and improve the survival rate. However, a series of problems, such as drug resistance, side effects, different evaluation criteria, and difficulties in selecting effective treatment strategies also exist in the process of anti-angiogenesis therapy, and thus, further studies are needed. This paper mainly reviews the clinical trials of anti-angiogenic drugs, main barriers in usage, as well as the feasible treatment strategies in clinical practice.