Ali imajo tarčna zdravila svoje mesto v radiokemoterapiji tumorjev prebavil? Do target drugs have its place in radiochemotherapy of gastrointestinal tumours?

Abstract

V zadnjem desetletju smo priča hitremu napredku v razumevanju tumorske biologije in imunologije rakov prebavil. Sočasno je prišlo do izboljšav v tehnikah obsevanja, zaradi katerih je lokalna kontrola bolezni boljša, saj je lahko doza na tumor večja, toksičnost na zdrava tkiva pa manjša. Skrb zbujajoč pa ostaja visok delež pojava oddaljenih zasevkov, kar nakazuje na potrebo po še agresivnejšem multimodalnem zdravljenju. Pričakovana dobrobit tarčnih zdravil pri nemetastatskih rakih prebavil je še vedno stvar kliničnih raziskav. Nujna je prepoznava prave populacije bolnikov in vključitev v raziskave ne glede na histologijo ali lokalizacijo tumorjev, pač pa glede na specifične molekularne in genetske nenormalnosti, torej glede na njihov specifični genetski profil.

Abstract (Eng)

In the last decade, we have been witnessing a rapid development of the understanding of tumour biology and immunology of gastrointestinal cancers. Simultaneously, there have been great improvements in radiation techniques, which have subsequently improved local disease control by enabling a larger dose on the tumour and reducing toxicity on healthy tissues. However, a high share of the occurrence of distant metastases remains of great concern, since it indicates the need for an even more aggressive multi-modal treatment. The expected benefit of target drugs in non-metastatic gastrointestinal cancers is still subject to clinical research. It is necessary to identify the right population of patients and include them in research, regardless of the histology or localisation of the tumours but based on specific molecular and genetic abnormalities, thus based on their specific genetic profile.