a Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI) , University of Genova , Italy.
b Academic Unit of Obstetrics and Gynecology , IRCCS Ospedale Policlinico San Martino , Genova , Italy.
Expert Opin Investig Drugs. 2019 Feb;28(2):131-142. doi: 10.1080/13543784.2018.1558202. Epub 2018 Dec 21.
Endometrial cancer (EC) is the most common neoplasm of the female genital tract in developed countries. Despite the progress in early detection and treatment, a significant number of cases of advanced ECs are still diagnosed. These patients have few treatment options and a poor prognosis. Our understanding of EC pathogenesis and progression has been enhanced by recent genomic studies. Among the relevant biological pathways, phosphatidylinositol 3-kinase/AKT (PIK3/AKT)-mammalian target of rapamycin (mTOR) signaling is frequently upregulated in this cancer.
This review covers investigational EC therapeutics acting on the PI3K/AKT/mTOR pathway. The authors review the results of clinical studies and highlight ongoing trials.
Several new agents are under evaluation for treating patients with metastatic, recurrent, and persistent EC. Clinical trials investigating PI3K/AKT/mTOR inhibitors have yielded controversial results. In the near future, new studies with dual inhibitors or multi-pathways inhibitors as mono or combination therapies with conventional chemotherapy (CT) or other targeted drugs may provide more promising data. Moreover, the evaluation of new serum and histological biomarkers is an attractive strategy for patient selection.
子宫内膜癌(EC)是发达国家女性生殖道最常见的肿瘤。尽管在早期检测和治疗方面取得了进展,但仍有相当数量的晚期 EC 病例被诊断出来。这些患者的治疗选择有限,预后较差。最近的基因组研究增强了我们对 EC 发病机制和进展的理解。在相关的生物学途径中,磷脂酰肌醇 3-激酶/AKT(PI3K/AKT)-雷帕霉素靶蛋白(mTOR)信号在这种癌症中经常被过度激活。
本文综述了作用于 PI3K/AKT/mTOR 通路的 EC 治疗的研究进展。作者综述了临床研究的结果,并强调了正在进行的试验。
有几种新的药物正在评估用于治疗转移性、复发性和持续性 EC 患者。针对 PI3K/AKT/mTOR 抑制剂的临床试验得出了相互矛盾的结果。在不久的将来,新的研究可能会提供更有希望的数据,包括双重抑制剂或多途径抑制剂作为单一或联合化疗(CT)或其他靶向药物的治疗方案。此外,评估新的血清和组织学生物标志物是一种有吸引力的患者选择策略。