Arnold Dirk, Peinert Stefan, Voigt Wieland, Schmoll Hans-Joachim
Martin-Luther-Universität Halle, Halle, Germany.
Oncologist. 2006 Jun;11(6):602-11. doi: 10.1634/theoncologist.11-6-602.
Despite advances in conventional and targeted anticancer therapy, the prognosis remains poor for many patients with solid tumors. Ongoing research into the molecular basis of malignant disease, however, has yielded many novel agents with potential activity, including the epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs).
This review summarizes current clinical data for EGFR-TKIs as monotherapy or in combination with 5-fluorouracil/leucovorin, irinotecan, or oxaliplatin, focusing on the rapidly developing area of colorectal, gastroesophageal, and pancreatic cancers.
EGFR-TKIs have limited but valuable activity as monotherapy in non-small cell lung cancer patients who have received prior anticancer treatment. The potential for application as a single agent in colorectal, gastroesophageal, and pancreatic cancers has yet to be demonstrated conclusively and deserves further investigation, especially as second- or third-line therapy. In combination with oxaliplatin-based regimens and 5-fluorouracil/leucovorin-based regimens, TKIs have shown benefits, suggesting that there may be a synergistic effect with chemotherapy. However, combinations with irinotecan-based regimens have been limited by toxicities.
EGFR-TKIs show benefits when used in combination with chemotherapy, and the favorable toxicity profiles observed suggest that these may be of value in frail or elderly patients.
尽管传统抗癌疗法和靶向抗癌疗法取得了进展，但许多实体瘤患者的预后仍然很差。然而，对恶性疾病分子基础的持续研究已经产生了许多具有潜在活性的新型药物，包括表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）。
本综述总结了EGFR-TKIs作为单一疗法或与5-氟尿嘧啶/亚叶酸、伊立替康或奥沙利铂联合使用的当前临床数据，重点关注结直肠癌、胃食管癌和胰腺癌等快速发展的领域。
EGFR-TKIs作为单一疗法在接受过先前抗癌治疗的非小细胞肺癌患者中具有有限但有价值的活性。在结直肠癌、胃食管癌和胰腺癌中作为单一药物应用的潜力尚未得到确凿证明，值得进一步研究，特别是作为二线或三线治疗。与基于奥沙利铂的方案和基于5-氟尿嘧啶/亚叶酸的方案联合使用时，TKIs已显示出益处，表明与化疗可能存在协同作用。然而，与基于伊立替康的方案联合使用受到毒性的限制。
EGFR-TKIs与化疗联合使用时显示出益处，观察到的良好毒性特征表明这些可能对体弱或老年患者有价值。
