Jones Suzanne
Sarah Cannon Cancer Center/Tennessee Oncology, 250 25th Avenue North, Suite 110, Nashville, TN 37203, USA.
Am J Health Syst Pharm. 2003 Dec 15;60(24 Suppl 9):S11-5. doi: 10.1093/ajhp/60.suppl_9.S11.
Drug costs and reimbursement issues for targeted therapies for lung cancer and how they affect pharmacy practice are discussed. Lung cancer is the most frequent cause of cancer death in the western world. Despite improvements in treatment results, less than 15% of patients survive five years after their primary diagnosis. Major advances in the understanding of cancer biology have led to the identification of several potential targets for cancer treatment. In non-small cell lung cancer (NSCLC) one of the most promising new targets has been the epidermal growth factor receptor (EGFR), which is overexpressed in most squamous cell subtypes and > or = 65% of adenocarcinomas and large cell subtypes. Gefitinib is an orally available small-molecule tyrosine kinase inhibitor that targets the intracellular domain of the EGFR. It has demonstrated activity and tolerable toxicity in patients with NSCLC. Because of its daily oral route of administration, patient compliance and education are of paramount importance, and the pharmacist plays an increasingly important role in patient management.
讨论了肺癌靶向治疗的药物成本和报销问题，以及它们如何影响药学实践。肺癌是西方世界癌症死亡的最常见原因。尽管治疗效果有所改善，但初诊后存活五年以上的患者不到15%。对癌症生物学认识的重大进展导致确定了几个癌症治疗的潜在靶点。在非小细胞肺癌（NSCLC）中，最有希望的新靶点之一是表皮生长因子受体（EGFR），它在大多数鳞状细胞亚型以及≥65%的腺癌和大细胞亚型中过度表达。吉非替尼是一种口服的小分子酪氨酸激酶抑制剂，靶向EGFR的细胞内结构域。它在NSCLC患者中已显示出活性和可耐受的毒性。由于其每日口服给药途径，患者的依从性和教育至关重要，药剂师在患者管理中发挥着越来越重要的作用。
