PARP抑制剂在卵巢癌中的临床应用及若干焦点问题

Clinical application of poly-ADP ribose polymerase inhibitors in ovarian cancer and several focuses

摘要:

卵巢癌是极具挑战性的妇科恶性肿瘤。目前缺乏有效的筛查手段，就诊时多为晚期，近20年其5年总生存率无明显改善。初始治疗后的反复复发最终进展为铂耐药，治疗难度及方案的选择越来越困难。近年来，大量研究致力于卵巢癌的靶向治疗。聚腺苷二磷酸核糖聚合酶抑制剂（poly-ADP ribose polymerase inhibitors，PARPi）的应用使上皮性卵巢的治疗正在发生迅速变化。本文就PARPi相关基因检测的现状，对初治、复发卵巢癌的维持治疗、复发性卵巢癌的后线治疗以及相关焦点问题进行总结，以期为PARPi更好地应用于临床提供参考。

Abstract:

Ovarian cancer is one of the most challenging gynecologic malignancies. The majority of patients tend to present late with advanced stage of disease given the lack of symptoms and no effective screening tests available. The 5-year overall survival has not obviously been improved nearly two decades. Although many patients display a good initial response to these conventional therapies, most of them experience relapse and ultimately develop platinum resistance, which makes the treatment and the choices more and more difficult. In recent years, a great deal of research has been devoted to targeted therapies. The application of poly-ADP ribose polymerase inhibitors (PARPi) is revolutionizing the treatment of epithelial ovaries. This article summarizes the current situations of PARPi-related genetic testing, maintenance treatment at initial and recurrent ovarian cancer, post-line treatment at recurrent ovarian cancer and related focal issues, in order to provide a reference for better clinical application of PARPi.