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头颈部鳞状细胞癌的精准治疗。

Precision Therapy of Head and Neck Squamous Cell Carcinoma.

机构信息

1 Department of Periodontics and Oral Medicine, Division of Oral Medicine, Pathology, and Radiology, University of Michigan School of Dentistry, Ann Arbor, MI, USA.

2 Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA.

出版信息

J Dent Res. 2018 Jun;97(6):614-621. doi: 10.1177/0022034518769645. Epub 2018 Apr 12.

Abstract

Precision medicine is an approach to disease prevention and treatment that takes into account genetic variability and environmental and lifestyle influences that are unique to each patient. It facilitates stratification of patient populations that vary in their susceptibility to disease and response to therapy. Shared databases and the implementation of new technology systems designed to advance the integration of this information will enable health care providers to more accurately predict and customize prevention and treatment strategies for patients. Although precision medicine has had a limited impact in most areas of medicine, it has been shown to be an increasingly successful approach to cancer therapy. Despite early promising results targeting aberrant signaling pathways or inhibitors designed to block tumor-driven processes such as angiogenesis, limited success emphasizes the need to discover new biomarkers and treatment targets that are more reliable in predicting response to therapy and result in better health outcomes. Recent successes in the use of immunity-inducing antibodies have stimulated increased interest in the use of precision immunotherapy of head and neck squamous cell carcinoma. Using next-generation sequencing, the precise profiling of tumor-infiltrating lymphocytes has great promise to identify hypoimmunogenic cancer that would benefit from a rationally designed combinatorial approach. Continued interrogation of tumors will reveal new actionable targets with increasing therapeutic efficacy and fulfill the promise of precision therapy of head and neck cancer.

摘要

精准医学是一种疾病预防和治疗的方法,它考虑到了每个患者特有的遗传变异性以及环境和生活方式的影响。它有助于对疾病易感性和治疗反应不同的患者人群进行分层。共享数据库和实施旨在推进信息整合的新技术系统,将使医疗保健提供者能够更准确地预测和定制患者的预防和治疗策略。尽管精准医学在大多数医学领域的影响有限,但它已被证明是癌症治疗中越来越成功的方法。尽管针对异常信号通路或旨在阻断血管生成等肿瘤驱动过程的抑制剂的早期有希望的结果,但有限的成功强调需要发现更可靠的新生物标志物和治疗靶点,以更好地预测治疗反应并改善健康结果。最近使用免疫诱导抗体的成功激发了对头颈部鳞状细胞癌精准免疫治疗的兴趣增加。使用下一代测序,对肿瘤浸润淋巴细胞的精确分析有望识别出受益于合理设计的组合方法的低免疫原性癌症。对肿瘤的持续研究将揭示具有更高治疗效果的新治疗靶点,并实现头颈部癌症精准治疗的承诺。

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