中国癌症杂志 ›› 2023, Vol. 33 ›› Issue (1): 14-24.doi: 10.19401/j.cnki.1007-3639.2023.01.002
收稿日期:
2023-01-03
修回日期:
2023-01-12
出版日期:
2023-01-30
发布日期:
2023-02-13
通信作者:
吴小华(ORCID: 0000-0002-6889-3541),博士,主任医师,复旦大学附属肿瘤医院妇瘤科主任。
作者简介:
郭勤浩(ORCID: 0000-0003-4661-481X),博士,主治医师。
GUO Qinhao(), YU Min, WU Xiaohua(
)
Received:
2023-01-03
Revised:
2023-01-12
Published:
2023-01-30
Online:
2023-02-13
Contact:
WU Xiaohua
文章分享
摘要:
2022年,国家癌症中心发布的最新数据显示,中国妇科肿瘤的发病率呈上升趋势,以卵巢癌为例,年新发病例数为57 200例,粗发病率为8.47/10万,年死亡病例数为27 200例,粗死亡率达4.04/10万,发病率和死亡率均高于世标率(分别为5.59/10万和2.45/10万),中国从事妇科肿瘤防治事业的医师面临更大的挑战。妇科肿瘤在早期经过规范性治疗后整体疗效较好,但对于晚期、复发转移的患者,有限的治疗模式及高复发率往往导致预后较差。近年来,靶向治疗、免疫治疗、抗体药物偶联物治疗等新兴治疗方式开创了妇科肿瘤治疗的新纪元,为妇科肿瘤患者带来了更多治疗希望。本文总结2022年度妇科肿瘤手术治疗、放疗、化疗、靶向治疗、免疫治疗和生物标志物检测等方面的重大进展,以期更好地指导妇科肿瘤个体化精准治疗。
中图分类号:
郭勤浩, 余敏, 吴小华. 2022年度妇科肿瘤诊治进展[J]. 中国癌症杂志, 2023, 33(1): 14-24.
GUO Qinhao, YU Min, WU Xiaohua. Progress in diagnosis and treatment of gynecological tumors in 2022[J]. China Oncology, 2023, 33(1): 14-24.
[1] |
RAMIREZ P T, FRUMOVITZ M, PAREJA R, et al. Minimally invasive versus abdominal radical hysterectomy for cervical cancer[J]. N Engl J Med, 2018, 379(20): 1895-1904.
doi: 10.1056/NEJMoa1806395 |
[2] |
RAMIREZ P, FRUMOVITZ M, PAREJA R, et al. Open vs. Minimally Invasive Radical Hysterectomy in Early Cervical Cancer: LACC Trial Final Analysis (LBA 10)[J]. Gynecol Oncol, 2022, 166: S53-S54.
doi: 10.1016/S0090-8258(22)01302-6 |
[3] | National Comprehensive Cancer Network. NCCN Guidelines for treatment of cervical cancer[J]. (2017-05-15)[2022-12-20]. https://www.nccn.org/professionals/physician_gls/pdf/cervical.pdf. |
[4] | CIBULA D, KÖHLER C, BAJSOVÁ S, et al. 526MO Pathological assessment of sentinel lymph node in early-stage cervical cancer: results from the prospective SENTIX trial (CEEGOG-CX01; ENGOT-CX2)[J]. Ann Oncol, 2022, 33: S786. |
[5] |
CHEN J, LI K, HAN Y, et al. 560P Neoadjuvant camrelizumab plus chemotherapy in patients with locally advanced cervical cancer (NACI): a prospective, single-arm, phase Ⅱ trial[J]. Ann Oncol, 2022, 33: S804.
doi: 10.1016/j.annonc.2022.07.688 |
[6] | MAYADEV J, ZAMARIN D, DENG W, et al. Safety and immunogenicity of Anti PD-L1 (atezolizumab) given as an immune primer or concurrently with extended field chemoradiotherapy for node positive locally advanced cervical cancer: an NRG Oncology trial (024)[J]. Gynecol Oncol, 2022, 166: S18-S19. |
[7] | Rodrigues M, Loap P, Dubot C, et al. 2022. Combination of nivolumab with chemoradiotherapy for locally advanced cervical cancer: NiCOL phase I trial [J]. American Society of Clinical Oncology. |
[8] | XIAO Y, CHENG H, WANG L, et al. 562P Camrelizumab plus concurrent chemoradiotherapy for locally advanced cervical cancer: preliminary results of a single-arm, open-label, phase Ⅱ trial[J]. Ann Oncol, 2022, 33: S805. |
[9] | MONK B, TOITA T, WU X H, et al. Durvalumab, in combination with and following chemoradiotherapy, in locally advanced cervical cancer: results from the phase 3 international, randomized, double-blind, placebo-controlled CALLA trial[R]. Oral Abstracts (Regular and Late-Breaking Submission). BMJ Publishing Group Ltd, 2022. |
[10] | NASIOUDIS D, RAMIREZ P T. 2022 Society of Gynecologic Oncology meeting report[J]. Int J Gynecol Cancer, 2022. [Online ahead of print] |
[11] | National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology. Cervical Cancer. Version 1. 2022[EB/OL]. [2022-12-20]. https://www.nccn.org/professionals/physician_gls/pdf/cervical. |
[12] | NODA K, TESHIMA K, IKEDA M, et al. Phase Ⅱ study of UFT in cancer of the uterine cervix[J]. Gan To Kagaku Ryoho, 1985, 12(4): 900-906. |
[13] |
NODA K, OHASHI Y, SUGIMORI H, et al. Phase Ⅲ double-blind randomized trial of radiation therapy for stage Ⅲb cervical cancer in combination with low- or high-dose Z-100: treatment with immunomodulator, more is not better[J]. Gynecol Oncol, 2006, 101(3): 455-463.
doi: 10.1016/j.ygyno.2005.11.006 |
[14] | FUJIWARA K, NISHIO S, YAMAMOTO K, et al. LBA31 Randomized phase Ⅲ trial of maintenance chemotherapy with tegafur-uracil versus observation following concurrent chemoradiotherapy for locally advanced cervical cancer, GOTIC-002 LUFT trial[J]. Ann Oncol, 2022, 33: S1398. |
[15] | TEWARI K S, COLOMBO N, MONK B J, et al. Pembrolizumab+chemotherapy in patients with persistent, recurrent, or metastatic cervical cancer: subgroup analysis of KEYNOTE-826[M]. American Society of Clinical Oncology, 2022. |
[16] | MONK B, TEWARI K, DUBOT C, et al. Patient-reported outcomes from the phase 3 randomized, double-blind, KEYNOTE-826 trial of pembrolizumab plus chemotherapy versus placebo plus chemotherapy for the first-line treatment of persistent, recurrent, or metastatic cervical cancer (023)[J]. Gynecol Oncol, 2022, 166: S18. |
[17] | LORUSSO D, VERGOTE I, O’CEARBHAILL R E, et al. Tisotumab vedotin (TV)+ pembrolizumab (pembro) in first-line (1L) recurrent or metastatic cervical cancer (r/mCC): interim results of ENGOT Cx8/GOG 3024/innovaTV 205[M]. American Society of Clinical Oncology, 2022. |
[18] |
OAKNIN A, MOORE K N, MEYER T, et al. 520MO Safety and efficacy of nivolumab (NIVO)±ipilimumab (IPI) in patients (pts) with recurrent/metastatic cervical cancer (R/M Cx Ca) in checkmate 358[J]. Ann Oncol, 2022, 33: S782.
doi: 10.1016/j.annonc.2022.07.648 |
[19] | WANG J, LOU H M, CAI H B, et al. A study of AK104 (an anti-PD1 and anti-CTLA4 bispecific antibody) combined with standard therapy for the first-line treatment of persistent, recurrent, or metastatic cervical cancer (R/M CC)[J]. J Clin Oncol, 2022, 40(16_suppl): 106. |
[20] | AN J S, WU L Y, LI X M, et al. Efficacy and safety of serplulimab (an anti-PD-1 antibody) combined with albumin-bound paclitaxel in patients with advanced cervical cancer who have progressive disease or intolerable toxicity after first-line standard chemotherapy (074)[J]. Gynecol Oncol, 2022, 166: S47. |
[21] |
TEWARI K S, MONK B J, VERGOTE I, et al. Survival with cemiplimab in recurrent cervical cancer[J]. N Engl J Med, 2022, 386(6): 544-555.
doi: 10.1056/NEJMoa2112187 |
[22] | XU Q, WANG J J, SUN Y, et al. Efficacy and safety of sintilimab plus anlotinib for PD-L1-positive recurrent or metastatic cervical cancer: a multicenter, single-arm, prospective phase Ⅱ trial[J]. J Clin Oncol, 2022, 40(16): 1795-1805. |
[23] | ZHENG M, Y ZHOU, ZHOU J, et al. 564P Efficacy and safety of tislelizumab plus anlotinib in the treatment of cervical cancer resistant to standard therapy: a prospective, single-arm, open labelled phase Ⅱ clinical trial[J]. Ann Oncol, 2022, 33: S806. |
[24] | OAKNIN A, BACKES F, VAN NIEUWENHUYSEN E, et al. LIO-1: initial phase 2 experience of lucitanib+nivolumab in patients with metastatic or recurrent cervical cancer (NCT04042116; ENGOT-GYN3/AGO/LIO) (034)[J]. Gynecol Oncol, 2022, 166: S24. |
[25] |
XIA L F, ZHOU Q, GAO Y N, et al. A multicenter phase 2 trial of camrelizumab plus famitinib for women with recurrent or metastatic cervical squamous cell carcinoma[J]. Nat Commun, 2022, 13(1): 7581.
doi: 10.1038/s41467-022-35133-4 pmid: 36481736 |
[26] |
O’MALLEY D M, NEFFA M, MONK B J, et al. Dual PD-1 and CTLA-4 checkpoint blockade using balstilimab and zalifrelimab combination as second-line treatment for advanced cervical cancer: an open-label phaseⅡ study[J]. J Clin Oncol, 2022, 40(7): 762-771.
doi: 10.1200/JCO.21.02067 |
[27] | WU X H, JI J F, LOU H M, et al. Efficacy and safety of cadonilimab, an anti-PD-1/CTLA4 bi-specific antibody, in previously treated recurrent or metastatic (R/M) cervical cancer: a multicenter, open-label, single-arm, phase Ⅱ trial (075)[J]. Gynecol Oncol, 2022, 166: S47-S48. |
[28] |
SIVARS L, HELLMAN K, CRONA GUTERSTAM Y, et al. Circulating cell-free tumor human papillomavirus DNA is a promising biomarker in cervical cancer[J]. Gynecol Oncol, 2022, 167(1): 107-114.
doi: 10.1016/j.ygyno.2022.07.028 pmid: 35918201 |
[29] |
NORPPA N, STAFF S, HELMINEN M, et al. Improved survival after implementation of ultra-radical surgery in advanced epithelial ovarian cancer: results from a tertiary referral center[J]. Gynecol Oncol, 2022, 165(3): 478-485.
doi: 10.1016/j.ygyno.2022.03.023 pmid: 35397919 |
[30] |
TANYI J L, RANDALL L M, CHAMBERS S K, et al. A phase Ⅲ study of pafolacianine injection (OTL38) for intraoperative imaging of folate receptor-positive ovarian cancer (study 006)[J]. J Clin Oncol, 2023, 41(2): 276-284.
doi: 10.1200/JCO.22.00291 |
[31] |
SEHOULI J, FOTOPOULOU C, VERGOTE I, et al. Role of cytoreductive surgery for the second ovarian cancer relapse in patients previously treated with chemotherapy alone at first relapse: a subanalysis of the DESKTOP Ⅲ trial[J]. J Clin Oncol, 2022, 40(16_suppl): 5520.
doi: 10.1200/JCO.2022.40.16_suppl.5520 |
[32] | LECURU F, SEHOULI J, VERGOTE I B, et al. 573P Role of CA125 in patients included in the DESKTOP Ⅲ/ENGOT-ov20 trial[J]. Ann Oncol, 2022, 33: S809. |
[33] |
ZHOU D C, LIU J H, LIU R H, et al. Effectiveness and safety of niraparib as neoadjuvant therapy in advanced ovarian cancer with homologous recombination deficiency (NANT): study protocol for a prospective, multicenter, exploratory, phase 2, single-arm study[J]. Front Oncol, 2022, 12: 852772.
doi: 10.3389/fonc.2022.852772 |
[34] |
LIM M C, CHANG S J, PARK B, et al. Survival after hyperthermic intraperitoneal chemotherapy and primary or interval cytoreductive surgery in ovarian cancer: a randomized clinical trial[J]. JAMA Surg, 2022, 157(5): 374-383.
doi: 10.1001/jamasurg.2022.0143 |
[35] |
FILIS P, MAURI D, MARKOZANNES G, et al. Hyperthermic intraperitoneal chemotherapy (HIPEC) for the management of primary advanced and recurrent ovarian cancer: a systematic review and meta-analysis of randomized trials[J]. ESMO Open, 2022, 7(5): 100586.
doi: 10.1016/j.esmoop.2022.100586 |
[36] |
FUJIWARA K, KRISTELEIT R, GHAMANDE S, et al. 178O Rucaparib maintenance treatment in patients (pts) with newly diagnosed ovarian cancer (OC): defining benefit according to disease risk subgroups within the phase Ⅲ ATHENA-MONO study[J]. Ann Oncol, 2022, 33: S1505-S1506.
doi: 10.1016/j.annonc.2022.10.214 |
[37] |
DISILVESTRO P, BANERJEE S, COLOMBO N, et al. 517O Overall survival (OS) at 7-year (y) follow-up (f/u) in patients (pts) with newly diagnosed advanced ovarian cancer (OC) and a BRCA mutation (BRCAm) who received maintenance olaparib in the SOLO1/GOG-3004 trial[J]. Ann Oncol, 2022, 33: S779.
doi: 10.1016/j.annonc.2022.07.645 |
[38] | RAY-COQUARD I L, LEARY A, PIGNATA S, et al. LBA29 Final overall survival (OS) results from the phase Ⅲ PAOLA-1/ENGOT-ov25 trial evaluating maintenance olaparib (ola) plus bevacizumab (bev) in patients (pts) with newly diagnosed advanced ovarian cancer (AOC)[J]. Ann Oncol, 2022, 33: S1396-S1397. |
[39] |
GAO Q L, ZHU J Q, ZHAO W D, et al. Olaparib maintenance monotherapy in Asian patients with platinum-sensitive relapsed ovarian cancer: phase Ⅲ trial (L-MOCA)[J]. Clin Cancer Res, 2022, 28(11): 2278-2285.
doi: 10.1158/1078-0432.CCR-21-3023 |
[40] | GSK. GSK provides an update on Zejula (niraparib) US prescribing information[EB/OL]. (2022-11-11)[2022-12-20]. https://www.gsk.com/en-gb/media/press-releases/gsk-provides-an-update-on-zejula-niraparib-us-prescribing-information/. |
[41] | MIRZA M, WU X, ZHU J, et al. VP7-2022: an ad-hoc interim overall survival results of niraparib with individualized starting dose as maintenance therapy in patients with platinum-sensitive recurrent ovarian cancer (NORA): a double-blind, randomized, placebo-controlled, phase Ⅲ trial[J]. Ann Oncol, 2022. [Online ahead of print] |
[42] |
KRISTELEIT R, OZA A M. Rucaparib for recurrent ovarian cancer with BRCA1 and BRCA2 mutations-authors’ reply[J]. Lancet Oncol, 2022, 23(7): e315.
doi: 10.1016/S1470-2045(22)00343-6 |
[43] | MATULONIS U, LORUSSO D, OAKNIN A, et al. Efficacy and safety of mirvetuximab soravtansine in patients with platinum-resistant ovarian cancer with high folate receptor alpha expression: results from the SORAYA study (LBA 4)[J]. Gynecol Oncol, 2022, 166: S50. |
[44] |
COLOMBO N, VAN GORP T, MATULONIS U A, et al. Overall survival data from a 3-arm, randomized, open-label, phase 2 study of relacorilant, a selective glucocorticoid receptor modulator, combined with nab-paclitaxel in patients with recurrent platinum-resistant ovarian cancer[J]. J Clin Oncol, 2022, 40(17_suppl): LBA5503.
doi: 10.1200/JCO.2022.40.17_suppl.LBA5503 |
[45] | O’MALLEY D, BARIANI G M, CASSIER P A, et al. 546P Pembrolizumab for microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) advanced endometrial cancer: long-term follow-up results from KEYNOTE-158[J]. Ann Oncol, 2022, 33: S796-S797. |
[46] |
TINKER A V, POTHURI B, GILBERT L, et al. 548P Progression-free survival (PFS) and overall survival (OS) in advanced/recurrent (AR) mismatch repair deficient/microsatellite instability-high or proficient/stable (dMMR/MSI-H or MMRp/MSS) endometrial cancer (EC) treated with dostarlimab in the GARNET study[J]. Ann Oncol, 2022, 33: S798-S799.
doi: 10.1016/j.annonc.2022.07.676 |
[47] |
MAKKER V, COLOMBO N, CASADO HERRAEZ A, et al. 525MO Updated efficacy and safety of lenvatinib (LEN) + pembrolizumab (pembro) vs treatment of physician’s choice (TPC) in patients (pts) with advanced endometrial cancer (aEC): study 309/KEYNOTE-775[J]. Ann Oncol, 2022, 33: S785-S786.
doi: 10.1016/j.annonc.2022.07.653 |
[48] | WU X, LIANG S, CHEN X, et al. 555P TQB2450 injection combined with anlotinib hydrochloride capsule in the treatment of advanced, recurrent or metastatic endometrial cancer: a multicohort, open label, multicenter phase Ⅱ clinical trial - The TQB2450-Ⅱ-08 trial[J]. Ann Oncol, 2022, 33: S802. |
[49] | BRADLEY W H, HAYES M P, TAYLOR N, et al. An open label, nonrandomized, multisite phase Ⅱ trial combining bevacizumab, atezolizumab, and rucaparib for the treatment of previously treated recurrent and progressive endometrial cancer[M]. American Society of Clinical Oncology, 2022. |
[50] | TAN D S, KIM Y M, LIM M C, et al. 101P Real-world prevalence of MSI-H/dMMR across 6 different tumor types in Asia[J]. Ann Oncol, 2022, 33: S585. |
[51] | ZHANG Q, MA X, CAO W, et al. 558P Molecular subtyping endometrial carcinoma in Chinese population applying an NGS-based classifier and its association with prognosis[J]. Ann Oncol, 2022, 33: S803. |
[52] | SIEGENTHALER F, TEIEN LANDE K, KRAKSTAD C, et al. 589P Circulating tumour DNA as prognostic factor in endometrial cancer: updated results from an international multicenter study[J]. Ann Oncol, 2022, 33: S816. |
[53] |
SHAPIRA-FROMMER R, MILESHKIN L, MANZYUK L, et al. Efficacy and safety of pembrolizumab for patients with previously treated advanced vulvar squamous cell carcinoma: results from the phase 2 KEYNOTE-158 study[J]. Gynecol Oncol, 2022, 166(2): 211-218.
doi: 10.1016/j.ygyno.2022.01.029 |
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