紫杉烷类在乳腺癌治疗中的作用。
The role of taxanes in the treatment of breast cancer.
作者信息
Nabholtz Jean-Marc, Gligorov Joseph
机构信息
La PrandieBreast Cancer Research Institute, 24290 Valojoulx, France.
出版信息
Expert Opin Pharmacother. 2005 Jun;6(7):1073-94. doi: 10.1517/14656566.6.7.1073.
Among the novel chemotherapeutic agents introduced in the last decade, the taxanes have emerged as the most powerful group of compounds, and results available so far confirm that they will be remembered in the future as the breast cancer chemotherapy of the 1990s. Two taxanes are available (paclitaxel and docetaxel) and they share some characteristics, although they do have some significant differences both in terms of their preclinical profile and, most importantly, their clinical characteristics. There are three main clinical differences: different efficacy-toxicity ratio in relation to dose and schedule; different integrability in anthracycline- and taxane-containing regimens, secondary to differences in pharmacokinetic interactions with anthracyclines; and different level of synergism between each taxane and trastuzumab. In clinical practice, the taxanes are now standard therapy in metastatic breast cancer. Their role as monochemotherapy or in combination with anthracyclines in advanced breast cancer has suggested their potential therapeutic impact in the treatment of patients with early breast cancer. Recent results in the adjuvant setting show that taxanes, used either in combination or in sequential therapy, possess the capability to induce significant improvements, in particular in terms of survival; thus confirming the positive impact of taxanes on the natural history of breast cancer. However, further results of all completed or ongoing Phase III trials in the early setting will help define the optimal use of taxanes and maximise the induced benefits for breast cancer patients.
在过去十年中引入的新型化疗药物中,紫杉烷类已成为最具效力的一类化合物,目前可得的结果证实,它们在未来将作为20世纪90年代的乳腺癌化疗药物而被铭记。有两种紫杉烷类药物可供使用(紫杉醇和多西他赛),它们有一些共同特征,尽管在临床前特征方面,尤其是临床特征方面存在一些显著差异。存在三个主要临床差异:与剂量和给药方案相关的不同疗效-毒性比;由于与蒽环类药物的药代动力学相互作用不同,在含蒽环类和紫杉烷类的方案中的不同整合性;以及每种紫杉烷与曲妥珠单抗之间不同程度的协同作用。在临床实践中,紫杉烷类目前是转移性乳腺癌的标准治疗方法。它们作为单药化疗或与蒽环类药物联合用于晚期乳腺癌的作用表明了其在早期乳腺癌患者治疗中的潜在治疗影响。辅助治疗环境中的最新结果表明,紫杉烷类无论是联合使用还是序贯治疗,都有能力带来显著改善,特别是在生存方面;从而证实了紫杉烷类对乳腺癌自然病程的积极影响。然而,早期环境中所有已完成或正在进行的III期试验的进一步结果将有助于确定紫杉烷类的最佳使用方法,并使乳腺癌患者获得的益处最大化。