中国实用外科杂志2025，Vol.45Issue(9)：1050-1055,6.DOI:10.19538/j.cjps.issn1005-2208.2025.09.17
甲状腺未分化癌治疗进展
Advances in the treatment of anaplastic thyroid carcinoma
摘要
Abstract
Anaplastic thyroid carcinoma(ATC)is a rare but highly aggressive thyroid malignancy with an extremely poor prognosis,and the median survival time is only 4-6 months.Traditional therapeutic modalities,including surgery,radiotherapy,and chemotherapy,provide limited overall efficacy.With advances in molecular biology,the genomic landscape of ATC has been gradually elucidated.Common alterations include BRAF V600E,TP53 mutations,TERT promoter mutations,and gene fusions involving NTRK,RET,and ALK,affecting signaling pathways such as RAS/RAF/MEK/ERK and PI3K/AKT/mTOR.Targeted therapies against specific alterations(e.g.,dabrafenib plus trametinib,larotrectinib,selpercatinib,pralsetinib)have markedly improved survival in selected patients.In the field of immunotherapy,programmed death-1(PD-1)and programmed death-ligand 1(PD-L1)inhibitors(e.g.,spartalizumab,pembrolizumab),administered alone or in combination with targeted therapy or radiotherapy,have shown promising efficacy.Combined immunotherapy and targeted therapy,such as the PD-L1 inhibitor atezolizumab with vemurafenib and cobimetinib,has significantly prolonged survival in patients harboring BRAF V600E mutations.Supportive care,including airway management,nutritional support,and management of adverse effects,remains essential.Multidisciplinary collaboration and individualized precision therapy are central to optimizing ATC management.Future research should focus on mechanisms of resistance and therapeutic strategies for patients without BRAF mutations.关键词
甲状腺未分化癌/综合治疗/分子机制/靶向治疗Key words
anaplastic thyroid carcinoma/multimodal therapy/molecular mechanisms/targeted therapy分类
医药卫生引用本文复制引用
王平,付鲜花,谢秋萍,徐逢雨..甲状腺未分化癌治疗进展[J].中国实用外科杂志,2025,45(9):1050-1055,6.基金项目
Project supported by the Young Scientists Found of the National Natural Science Foundation of China(No.82303597) 国家自然科学基金青年科学基金项目(No.82303597) （No.82303597）
