Bonomi Philip D
Section of Medical Oncology, Rush University Medical Center, 1725 West Harrison Street, Suite 821, Chicago, IL 60612, USA.
Am J Health Syst Pharm. 2003 Dec 15;60(24 Suppl 9):S16-21. doi: 10.1093/ajhp/60.suppl_9.S16.
Epidermal growth factor receptor-targeted therapy and symptom improvement in non-small cell lung cancer are discussed. Non-small cell lung cancer (NSCLC) is a common and frequently incurable disease. Patients with advanced stage IIIB/IV disease, although not candidates for curative resection, can benefit from treatment that prolongs survival, alleviates symptoms, and reduces complications. While incremental advances have occurred with the use of chemotherapy and radiation therapy, the benefits have been largely palliative. Moreover, the adverse events associated with these therapies may undermine the treatment goal by replacing disease-related symptoms with treatment-related adverse events. Thus, novel, more targeted approaches are needed. Increased understanding of cellular and molecular biology has resulted in the development of treatments that selectively target key regulatory pathways and molecules involved in cell growth and metastasis. Gefitinib is one member of a new class of targeted anticancer agents known as tyrosine kinase inhibitors with activity against NSCLC. In clinical trials, gefitinib has produced responses in patients with relapsed or refractory NSCLC, reduced disease-related symptoms, and has been associated with improvements in quality of life. Such targeted therapy may have a significant impact on the treatment of patients with NSCLC.
本文讨论了表皮生长因子受体靶向治疗与非小细胞肺癌症状改善的相关内容。非小细胞肺癌(NSCLC)是一种常见且通常难以治愈的疾病。晚期IIIB/IV期患者虽不适合进行根治性切除,但可从延长生存期、缓解症状及减少并发症的治疗中获益。尽管化疗和放疗取得了渐进性进展,但其益处主要是姑息性的。此外,这些疗法相关的不良事件可能会用与治疗相关的不良事件取代与疾病相关的症状,从而破坏治疗目标。因此,需要新的、更具针对性的方法。对细胞和分子生物学的深入了解促使了能够选择性靶向参与细胞生长和转移的关键调控途径及分子的治疗方法的发展。吉非替尼是一类新型靶向抗癌药物(称为酪氨酸激酶抑制剂)的成员之一,对NSCLC具有活性。在临床试验中,吉非替尼已使复发或难治性NSCLC患者产生反应,减轻了与疾病相关的症状,并与生活质量的改善相关。这种靶向治疗可能会对NSCLC患者的治疗产生重大影响。