2023指南出炉！软骨肉瘤治疗药物汇总

Chondrosarcoma is a common malignant tumor. The main site of onset is the medullary cavity, the main site of onset is the periosteum, and a small number of cases are on soft tissue. Tumors commonly occur in the long bones of the limbs and pelvis, but can also be found in the vertebrae, sacrum, clavicle, scapula and foot bones. This article summarizes the drugs related to chondrosarcoma. Please follow the editor to learn more~

1. Chondrosarcoma

Primary chondrosarcoma mainly presents with dull pain, which ranges from intermittent to persistent, and patients adjacent to joints will experience symptoms of limited joint mobility. A lump can be palpated locally, but there is no obvious tenderness, and the surrounding skin is red and hot.

Secondary chondrosarcoma most commonly occurs in the pelvis, followed by the scapula, femur and humerus. A lump is discovered accidentally. The course of the disease is slow and the pain is not obvious. The surrounding skin will not appear red and hot. However, when it is close to the joint, it will cause joint swelling and limited movement. If it is put under pressure, symptoms such as radiating pain and numbness will appear.

(Chondrosarcoma, picture from Baidu Encyclopedia, infringement will be deleted)

Tumors located in the chest and pelvis are difficult to detect until they compress internal organs and cause symptoms.

2. Summary of Chondrosarcoma Drugs

1.

Ivonib (Tosuvo) is China's first approved potent oral targeted inhibitor for isocitrate dehydrogenase-1 (IDH1) mutated cancer. In AML patients, the genetic mutation that causes an increase in 2-hydroxyglutarate content in leukemia cells is called a susceptible IDH1 gene mutation, and ivonib can inhibit the enzyme activity of IDH1 gene mutations. Therefore, ivonib can be used in the treatment of certain acute myeloid leukemias.

On February 9, 2022, China’s National Medical Products Administration approved the new drug marketing application for ivonib, the first drug of its kind. This is the first approved IDH1 inhibitor in China and is mainly used for the treatment of adult drug-resistant AML patients with IDH1 gene mutations.

2.

Ensidipine is an isocitrate dehydrogenase 2 (IDH2) inhibitor and is widely used clinically. The tricarboxylic acid cycle (TCA cycle) is the core of many biochemical signal transduction pathways. IDH2 is the core enzyme of the tricarboxylic acid cycle. Ensidipine can promote the differentiation of leukemia cells by reducing 2-HG levels, so it can be used to treat adult patients with relapsed or refractory acute myeloid leukemia (AML).

Ensidipine is a drug approved for marketing by the U.S. Food and Drug Administration on August 1, 2017. It is mainly used in the treatment of adults with IDH2 gene mutation-resistant AML. It also approved Abbott's companion diagnostic kit.

3.

Ifosfamide is an anti-tumor drug with strong anti-tumor activity. It can inhibit DNA synthesis and interfere with the function of RNA. Therefore, it has a wide anti-tumor spectrum and can be used for soft tissue tumors, testicular tumors, malignant lymphoma, lung cancer, breast cancer, ovary, cervical cancer and children's tumors.

Ye Zhaoming's team, director of the Department of Orthopedics at the Second Affiliated Hospital of Zhejiang University School of Medicine and director of the Institute of Orthopedics of Zhejiang University, published a relevant research paper online in the authoritative oncology journal "Clinical Cancer Research". They conducted an immune typing of common chondrosarcoma and found that there is an "immune failure" subtype in common chondrosarcoma, and patients who benefited from PD-1 antibody immunotherapy in clinical treatment were all consistent with this subtype. The mechanism includes tumor IDH1/2 mutations, which promote immune cells to gather into the tumor and recognize it.