2023年美国临床肿瘤学年会软组织肉瘤治疗进展

Progress in the treatment of soft tissue sarcoma in the 2023 annual meeting of the American Society of Clinical Oncology

软组织肉瘤是一组起源于间叶组织的罕见恶性肿瘤, 其恶性程度高且病理亚型繁多, 不同亚型预后不尽相同, 不同病理亚型的治疗方式也不相同。手术治疗依然是目前主要的治疗方式, 而免疫及靶向治疗的发展也为软组织肉瘤的治疗带来新希望。免疫检查点抑制剂、溶瘤病毒疗法以及T细胞疗法在临床试验中展现出较好的安全性与疗效, 曲贝替定、乐伐替尼等靶向药物改变了软组织肉瘤的治疗格局。目前对于远处转移的晚期软组织肉瘤患者, 以阿霉素和异环磷酰胺为基础的化疗依然是一线治疗方案, 但阿霉素的不良反应限制了其在老年患者中的应用, 曲磷胺作为其替代方案在临床试验中展现了较好的疗效与安全性。术后放疗疗效已得到证实, 可以降低软组织肉瘤外科切除术后的局部复发率。多模式综合治疗已成为软组织肉瘤治疗的主要策略, 不同治疗手段之间的联合使用可以产生协同效应, 帮助患者获得更多的临床受益, 如阿霉素与免疫检查点抑制剂的联合使用, 抗血管生成药物与化疗药物的联合使用等。在2023年美国临床肿瘤学会(ASCO)召开的年会中, 来自世界各地的肿瘤学者报道了许多软组织肉瘤治疗相关研究, 文章旨在总结了2023年ASCO年会中软组织肉瘤治疗新进展, 以期为临床治疗提供参考。

Soft tissue sarcoma(STS)is a group of rare malignant tumors originating from mesenchymal tissue,with a high degree of malignancy and a wide range of pathological subtypes.The prognosis varies among different subtypes,and treatment increasingly relies on selecting appropriate treatment methods for different subtypes.Surgical treatment is still the main treatment method at present,and the development of immune and targeted therapy also brings new hope for the treatment of soft tissue sarcoma.Immune checkpoint inhibitors,oncolytic viruses and T cell therapy have shown well safety and efficacy in clinical trials.Targeted drugs such as trabectedin and lenvatinib have changed the treatment pattern of soft tissue sarcoma.Currently,chemotherapy based on doxorubicin and ifosfamide is still the first line treatment for patients with advanced soft tissue sarcoma who have distant metastasis.However,the adverse reactions of doxorubicin limit its application in elderly patients,and trofosfamide has shown good efficacy and safety as an alternative in clinical trials.The efficacy of postoperative radiotherapy has been confirmed,which can reduce the local recurrence rate after surgical resection of soft tissue sarcoma.In summary,multimodal comprehensive treatment has become the main strategy for the treatment of soft tissue sarcoma.The combination of different treatment methods can generate synergistic effects and help patients obtain more clinical benefits,such as the combination of doxorubicin and immune checkpoint inhibitors,and the combination of antiangiogenic drugs and chemotherapy drugs.At the 2023 annual meeting of the American Society of Clinical Oncology(ASCO),oncologists from all over the world reported many researches related to the treatment of soft tissue sarcoma.This article aims to review the new progress in the treatment of soft tissue sarcoma in the 2023 annual meeting of ASCO.