Současné možnosti predikce léčebné odpovědi na neoadjuvantní chemoradioterapii u karcinomu konečníku

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Autoři: Pazdírek F. ¹; Minárik M. ²; Benešová L. ³; Lohynská R. ⁴; Hoch J. ¹
Působiště autorů: Department of Surgery, 2nd Medical Faculty, Charles University and University Hospital Motol, Prague 2 Elphogene, Prague 3 Center for Applied Genomics of Solid Tumors (CEGES), Genomac Research Institute, Prague 4 Department of Oncology, 1st Faculty of Med ¹
Vyšlo v časopise: Gastroent Hepatol 2020; 74(5): 393-403
Kategorie: literary review and commentary

Souhrn

Standardem léčby pacientů s lokálně pokročilým karcinomem konečníku je neoadjuvantní chemoterapie v kombinaci s radiací. Hlavním cílem léčby je snížit riziko rekurence. S léčbou však mohou být spojeny také závažné nežádoucí účinky v důsledku postradiačního poškození v oblasti pánve. Mnoho skupin se snaží najít markery, které by umožňovaly předpovídat odpověď na léčbu. Tento přehledový článek přináší rešerši literatury provedenou za účelem identifikace hlavních studií zaměřených na použití klinických, radiologických, imunologických a molekulárních (proteinových, DNA a RNA) markerů. Pro každou skupinu předkládáme souhrn poznatků. Obecně lze shrnout, že interpretace v současné době získaných poznatků je spojena s určitou mírou nejednoznačnosti a nejednotnosti. Zdá se, že i v nejslibnější oblasti cirkulujících molekulárních biomarkerů je zapotřebí dalšího výzkumu, než bude možné stanovit jejich užitečnost v klinické praxi.

Klíčová slova:

karcinom konečníku – neoadjuvantní chemoradioterapie – cirkulující nádorová ctDNA – predikce – prognóza – odpověď – biomarker

Zdroje

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