臨床整形外科54巻7号

2019年07月発行

誌上シンポジウム 骨軟部腫瘍の薬物治療アップデート

軟部肉腫に対する化学療法

著者： 田仲和宏¹

所属機関： ¹大分大学医学部整形外科・人工関節学講座

ページ範囲：P.677 - P.682

　軟部肉腫に対する化学療法のkey drugは，現在でもアドリアマイシン(ADM)とイホスファミド(IFM)である．限局性軟部肉腫においては，四肢・体幹部発生のハイリスク症例に対して，ADM＋IFM(AI)療法が標準レジメンとして推奨される．進行軟部肉腫に対する一次治療ではADM単剤あるいはAI療法が標準的である．二次治療以降では，ゲムシタビン＋ドセタキセル併用療法，パゾパニブ，トラベクテジン，エリブリンなど治療選択肢が拡がっている．最近，がん種横断的に，高頻度のmicrosatellite instabilityを有する固形腫瘍に対する抗PD-1抗体薬，NTRK融合遺伝子を持つ固形腫瘍に対するTRK阻害剤が適応承認された．遺伝子パネル検査を用いたがんゲノム医療も保険適用となる見込みであり，軟部肉腫の薬物療法はこれまでと全く異なる新時代を迎えている．

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