原发不明恶性肿瘤长期缺乏个性化治疗方法，成为肿瘤诊治领域的难题。近日，中国医学专家团队经过七年研究，在《柳叶刀·肿瘤学》发表重要临床研究，证实了对原发不明肿瘤进行“部位特异性治疗”的有效性。
复旦大学附属肿瘤医院肿瘤内科胡夕春教授、罗志国教授领衔的团队，通过基因检测技术预测原发不明肿瘤患者的肿瘤组织起源，并进行“部位特异性治疗”的患者，中位无进展生存期达到9.6个月，显著优于传统经验性化疗的6.6个月，疾病进展风险降低32%，中位总生存期延长9个月。这一研究成果有望成为原发不明肿瘤患者治疗的新选择。
原发不明肿瘤因原发病灶无法确认而得名，患者常常表现为“诊断时仅发现转移灶却无法发现原发病灶”，是一类恶性肿瘤，患者死亡率高，疗效停滞不前。由于缺乏相关研究，目前原发不明肿瘤患者的标准治疗方法仍然是凭借医生经验的“经验性化疗”。
胡夕春教授表示，这种“眉毛、胡子一起抓”的治疗方法已经严重滞后于当前的肿瘤学发展，无法实现对肿瘤的更精准、个性化打击。2017年，胡夕春教授、罗志国教授团队开展了名为“Fudan CUP-001”的临床研究，旨在通过基因检测技术，更精准推断原发不明肿瘤患者的原发灶，并实现临床治疗的个性化、精准化，突破既往治疗的“瓶颈”。
研究表明，“部位特异性治疗”相比“经验性化疗”能够显著改善初治原发不明肿瘤患者的无进展生存期，可成为未来原发不明肿瘤患者精准治疗的新选择。
《柳叶刀·肿瘤学》同期发表的述评也高度评价了该项研究，并指出：“未来，在原发不明肿瘤临床实践中，部位特异性治疗将成为新的原发不明肿瘤诊疗标准，推荐使用基因表达谱检测指导治疗。”这一突破有望为原发不明肿瘤患者带来新的希望。
英语如下：
Title: “Shanghai Experts Crack the Treatment Challenge of Primary Undiagnosed Tumors”
Keywords: Shanghai Experts, Primary Undiagnosed, New Treatment Options
Content:
For years, the lack of personalized treatment methods for primary undiagnosed malignant tumors has been a conundrum in the field of oncology. Recently, a Chinese medical expert team, after seven years of research, published a significant clinical study in The Lancet Oncology, which confirmed the effectiveness of “site-specific treatment” for primary undiagnosed tumors.
The team led by Professor Hu Xi-chun and Professor Luo Zhi-guo from the Department of Oncology at Fudan University Cancer Hospital, used gene testing technology to predict the origin of tumors in patients with primary undiagnosed tumors and treated them with “site-specific treatment.” The median progression-free survival time for these patients reached 9.6 months, significantly better than the 6.6 months achieved with traditional empiric chemotherapy, and the risk of disease progression was reduced by 32%, with a median overall survival time extended by 9 months. This research has the potential to become a new treatment option for patients with primary undiagnosed tumors.
Tumors classified as primary undiagnosed occur when the primary site of the tumor cannot be confirmed, and patients often present with “only finding metastatic lesions at diagnosis without discovering the primary site.” These are a type of malignant tumor with a high mortality rate and stagnant treatment outcomes. Due to a lack of relevant research, the standard treatment method for patients with primary undiagnosed tumors currently relies on “empiric chemotherapy” based on the doctor’s experience.
Professor Hu expressed that this “one-size-fits-all” treatment approach is seriously outdated and cannot achieve a more precise and personalized attack on tumors. In 2017, the team led by Professor Hu and Professor Luo initiated a clinical study named “Fudan CUP-001,” aiming to use gene testing technology to make a more precise estimation of the primary site of tumors in patients with primary undiagnosed tumors and to achieve personalized and precise clinical treatment, breaking through the “bottleneck” of previous treatments.
The study showed that “site-specific treatment” significantly improves the progression-free survival of patients with primary undiagnosed tumors who are newly diagnosed, and can become a new option for precise treatment of patients with primary undiagnosed tumors in the future.
An accompanying editorial in The Lancet Oncology also highly praised this research and stated: “In the clinical practice of primary undiagnosed tumors in the future, site-specific treatment will become the new standard for the diagnosis and treatment of primary undiagnosed tumors, recommending the use of gene expression profiling to guide treatment.” This breakthrough is expected to bring new hope to patients with primary undiagnosed tumors.
【来源】http://www.chinanews.com/life/2024/07-29/10259607.shtml
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