恶性周围神经鞘瘤靶向治疗的研究进展

Targeted therapy for malignant peripheral nerve sheath tumor: translational research and clinical application

恶性周围神经鞘瘤(MPNST)是一种少见的起源于外周神经分支和神经鞘膜的侵袭性软组织肉瘤。早期根治性手术是MPNST有效的治疗方式,但由于MPNST对放疗和化疗的敏感性低,疾病进展迅速,预后通常较差,死亡率高。近年来,寻找MPNST演进的驱动因素及治疗靶点的转化研究和临床试验发展迅速,涉及NF1-Ras途径、Raf-MEK-ERK途径、PI3K-AKT-mTOR途径、Wnt信号通路、凋亡蛋白的异常表达、多梳抑制复合物2普遍缺失、HDAC家族高表达、受体酪氨酸激酶异常、细胞程序性死亡配体表达、极光激酶表达以及多种微小RNA等方面。文章归纳了与MPNST相关的潜在治疗靶点的转化研究,并对正在研发的靶向药物及其临床试验进行总结,为MPNST靶向治疗的临床应用提供有效信息。

Malignant peripheral nerve sheath tumor (MPNST) is a rare invasive soft tissue sarcoma that originates from peripheral nerve branches and peripheral nerve sheaths. Early radical surgery is an effective treatment for MPNST. Since it is insensitive to radiotherapy and chemotherapy, the disease manifests a rapid progression, poor prognosis and high mortality. In recent years, the translational researches on the driving factors and therapeutic targets of MPNST have been rapidly developed, including the pathways of NF1-Ras, Raf-MEK-ERK, PI3K-AKT-mTOR, Wnt signaling, and abnormal expressions of apoptotic proteins, the general loss of polycomb repressive complex 2 (PRC2), upregulation of the HDAC family, abnormal expressions of receptor tyrosine kinases, expressions of programmed cell death ligand (PD-L1), aurora kinase and various microRNAs.This review summarizes the current translational researches on potential therapeutic targets of MPNST, and the clinical trials which provide helpful information for MPNST targeted therapy.