Markman Maurie
University of Texas, M.D. Anderson Cancer Center, Houston, TX 77030-4009, USA.
J Exp Ther Oncol. 2004 Jul;4(2):131-6.
Significant progress has been made in the management of advanced ovarian cancer. Response rates to platinum-based chemotherapy are respectable; however, recurrence continues to be the rule rather than the exception. Chemotherapy is administered as initial treatment and for disease recurrence, often over a period of many years--thus ovarian cancer is considered a chronic disease by many oncologists. The importance of the taxanes in the treatment of ovarian cancer is well established. However, taxanes are associated with numerous toxicities, resulting in the need for alternative dosing strategies that produce fewer side effects, or the discovery of novel taxanes with equivalent anti-tumor activity, but a more favorable toxicity profile. Several taxanes are in development including CT-2103, a macromolecule consisting of paclitaxel conjugated to a biodegradable, water-soluble polymer of glutamic acid. Clinical data of CT-2103 as a single agent and in combination have demonstrated activity in previously treated ovarian cancer patients, both in platinum-sensitive and platinum-resistant disease. CT-2103 appears to be potentially associated with a more favorable toxicity profile relative to paclitaxel, and enhanced solubility allows for a 10-minute infusion. Ongoing trials employing this agent will focus on extending survival, optimizing quality of life, and defining a possible role for CT-2103 in the standard management of advanced ovarian cancer.
晚期卵巢癌的治疗已取得显著进展。铂类化疗的缓解率可观；然而，复发仍是常态而非例外。化疗作为初始治疗手段以及针对疾病复发的治疗方式，常常持续多年——因此许多肿瘤学家将卵巢癌视为一种慢性病。紫杉烷类药物在卵巢癌治疗中的重要性已得到充分确立。然而，紫杉烷类药物伴有众多毒性反应，这就需要采用能产生较少副作用的替代给药策略，或者研发出具有同等抗肿瘤活性但毒性特征更优的新型紫杉烷类药物。几种紫杉烷类药物正处于研发阶段，包括CT - 2103，它是一种由紫杉醇与可生物降解的水溶性谷氨酸聚合物偶联而成的大分子。CT - 2103作为单一药物及联合用药的临床数据已证明，其对既往接受过治疗的卵巢癌患者（包括铂敏感和铂耐药疾病患者）均有活性。与紫杉醇相比，CT - 2103似乎可能具有更优的毒性特征，且其增强的溶解性使得输注时间可缩短至10分钟。正在进行的使用该药物的试验将聚焦于延长生存期、优化生活质量以及明确CT - 2103在晚期卵巢癌标准治疗中的可能作用。
