Disulfiram như một tác nhân điều trị cho Melanoma ác tính di căn—Huyền thoại cũ hay biểu tượng mới?

Cancers - Tập 12 Số 12 - Trang 3538
Francisco Meraz-Torres1, Sarah Plöger1, Claus Garbe1, Heike Niessner1,2, Tobias Sinnberg1,2
1Center for Dermatooncology, Department of Dermatology, University Hospital Tübingen, 72076 Tübingen, Germany
2Cluster of Excellence iFIT (EXC 2180) Image Guided and Functionally Instructed Tumor Therapies, University Hospital Tübingen, 72076 Tübingen, Germany

Tóm tắt

Các khái niệm liệu pháp mới như liệu pháp miễn dịch dựa trên anti-PD-1 hoặc liệu pháp nhắm mục tiêu với các chất ức chế BRAF và MEK đã cải thiện đáng kể tỷ lệ sống sót cho bệnh nhân melanoma. Tuy nhiên, khoảng 20% bệnh nhân điều trị nhắm mục tiêu và lên tới 50% bệnh nhân điều trị miễn dịch không đáp ứng với liệu pháp điều trị đầu tay của họ hoặc nhanh chóng phát triển kháng thuốc. Hơn nữa, hiện tại không có liệu pháp nhắm mục tiêu nào được phê duyệt cho một số tiểu nhóm nhất định, chẳng hạn như melanoma kiểu hoang dã BRAF, mặc dù chúng thường mang sinh học khối u hung hãn. Việc tái sử dụng các loại thuốc đã được phê duyệt trước đây là một chiến lược đầy hứa hẹn để lấp đầy khoảng trống này, vì nó sẽ dẫn đến chi phí tương đối thấp, giảm rủi ro và tiết kiệm thời gian. Disulfiram (DSF), loại thuốc đầu tiên dùng để điều trị nghiện rượu, được Cục Quản lý Thực phẩm và Dược phẩm Hoa Kỳ phê duyệt hơn 60 năm trước, là một ứng viên thuốc như vậy. Có ngày càng nhiều bằng chứng cho thấy DSF có tiềm năng lớn trong việc điều trị nhiều loại ung thư ở người, bao gồm melanoma. Một số cơ chế hoạt động chống khối u của nó đã được xác định, trong đó có việc ức chế hệ thống ubiquitin-proteasome, kích thích các gốc oxy phản ứng và nhiều con đường tín hiệu chết khác nhau. Bài báo này cung cấp cái nhìn tổng quan về việc áp dụng DSF ở người, các cơ chế phân tử và các mục tiêu trong liệu pháp ung thư với trọng tâm là melanoma. Kết quả của các nghiên cứu lâm sàng và các phương pháp kết hợp thử nghiệm giữa DSF với các liệu pháp ung thư khác nhau sẽ được thảo luận, với mục tiêu khám phá tiềm năng của DSF trong liệu pháp điều trị melanoma.

Từ khóa


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