甲状旁腺癌药物治疗进展

Update on the medical management of parathyroid carcinoma

甲状旁腺癌是一种少见的内分泌恶性肿瘤, 近年来其发病率不断升高。大部分甲状旁腺癌患者会出现复发转移, 整体预后不良。对于不可手术切除的甲状旁腺癌, 药物治疗是其主要治疗手段。目前治疗甲状旁腺癌的可选药物种类有限, 治疗效果仍不理想。随着研究深入, 陆续有文献报道将新型药物用于治疗甲状旁腺癌。以控制高钙血症为目的的内分泌治疗药物在以往双膦酸盐的基础上新增了拟钙剂及核因子κB受体激活蛋白配体抑制剂, 以直接杀伤肿瘤细胞为目的的肿瘤靶向及免疫治疗也在甲状旁腺癌的治疗中展现出一定的效果。以上新药的出现为解决这一临床难点问题带来了曙光, 后续的临床疗效仍有待进一步研究。

Parathyroid carcinoma is a rare endocrine malignancy with an increasing rate of incidence.Most parathyroid carcinoma patients will develop local recurrence or metastases leading to poor prognosis.Medical management is the mainstay of treatment for patients with unresectable parathyroid carcinoma.However,the therapeutic outcome of medical management remains unsatisfactory restricted by limited options and efficacy.With the deepening of research,several novel drugs have been reported to be applied in the treatment of parathyroid carcinoma.Calcimimetics and receptor activator for nuclear factor-κB ligand inhibitors aiming to control hypercalcemia have been applied in the endocrine therapy of parathyroid carcinoma.Besides,preliminary studies have shown the therapeutic effects of targeted therapy and immunotherapy on parathyroid carcinoma.These new drugs have shed light on this clinical dilemma;however,their clinical efficacy remains to be determined.In this article,the recent progress in the medical management of parathyroid carcinoma is updated.