A framework for fibrolamellar carcinoma research and clinical trials.
Nat Rev Gastroenterol Hepatol
; 19(5): 328-342, 2022 05.
Article
de En
| MEDLINE
| ID: mdl-35190728
ABSTRACT
Fibrolamellar carcinoma (FLC), a rare, lethal hepatic cancer, occurs primarily in adolescents and young adults. Unlike hepatocellular carcinoma, FLC has no known association with viral, metabolic or chemical agents that cause cirrhosis. Currently, surgical resection is the only treatment demonstrated to achieve cure, and no standard of care exists for systemic therapy. Progress in FLC research illuminates a transition from an obscure cancer to one for which an interactive community seems poised to uncover fundamental mechanisms and initiate translation towards novel therapies. In this Roadmap, we review advances since the seminal discovery in 2014 that nearly all FLC tumours express a signature oncogene (DNAJB1-PRKACA) encoding a fusion protein (DNAJ-PKAc) in which the J-domain of a heat shock protein 40 (HSP40) co-chaperone replaces an amino-terminal segment of the catalytic subunit of the cyclic AMP-dependent protein kinase (PKA). Important gains include increased understanding of oncogenic pathways driven by DNAJ-PKAc; identification of potential therapeutic targets; development of research models; elucidation of immune mechanisms with potential for the development of immunotherapies; and completion of the first multicentre clinical trials of targeted therapy for FLC. In each of these key areas we propose a Roadmap for future progress.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Carcinome hépatocellulaire
/
Tumeurs du foie
Type d'étude:
Clinical_trials
Limites:
Adolescent
/
Adult
/
Humans
Langue:
En
Journal:
Nat Rev Gastroenterol Hepatol
Sujet du journal:
GASTROENTEROLOGIA
Année:
2022
Type de document:
Article
Pays d'affiliation:
États-Unis d'Amérique