Gilewski T A, Golomb H M
Section of Hematology/Oncology, University of Chicago Medical Center, IL 60637.
Semin Oncol. 1990 Feb;17(1 Suppl 1):3-10; discussion 38-41.
The recent large-scale production of biomodulators, also known as biologic response modifiers, made possible through recombinant DNA technology, offers the potential for significant advances in the treatment of cancer. The antitumor activity of these agents, such as interferons, interleukins, and tumor necrosis factor, have generated enthusiasm for further investigation. In an effort to improve response rates, combinations of these agents both with and without conventional therapies are currently being examined. Clinical trials have been conducted with various therapeutic combinations, including a biomodulator plus chemotherapy, combinations of different biomodulators, a biomodulator with concomitant chemotherapy and radiation, and multiple combinations of chemotherapies and biomodulators. These approaches are promising and some limited successes have been reported; however, the goal of increased anticancer activity without greater toxicities or antagonism between various agents is not always achieved. Synergism among active agents is not necessarily assured and quite unexpected and unpredictable toxicities have been noted. The studies to date suggest that important new therapies will emerge, but many questions have to be answered before the specific roles of these new treatments are defined.
通过重组DNA技术实现的生物调节剂（也称为生物反应调节剂）的近期大规模生产，为癌症治疗取得重大进展提供了潜力。这些药物，如干扰素、白细胞介素和肿瘤坏死因子的抗肿瘤活性，激发了进一步研究的热情。为了提高缓解率，目前正在研究这些药物与传统疗法联合或不联合使用的情况。已经对各种治疗组合进行了临床试验，包括生物调节剂加化疗、不同生物调节剂的组合、生物调节剂与同步化疗和放疗，以及化疗和生物调节剂的多种组合。这些方法很有前景，并且已经报道了一些有限的成功；然而，在不增加毒性或不同药物之间不产生拮抗作用的情况下提高抗癌活性的目标并不总是能够实现。活性剂之间的协同作用不一定能保证，并且已经注意到相当意外和不可预测的毒性。迄今为止的研究表明，将会出现重要的新疗法，但在确定这些新疗法的具体作用之前，还有许多问题需要回答。
