Grothey Axel
Division of Medical Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Oncology (Williston Park). 2006 Dec;20(14 Suppl 10):21-8.
Traditional therapeutic concepts and treatment regimens for colorectal cancer are currently changing with the demonstration of the efficacy of biologic agents in this disease setting. The addition of the anti-vascular endothelial growth factor (VEGF) monoclonal antibody bevacizumab (Avastin) to conventional chemotherapy in the first- and second-line settings has shown a survival benefit; this outcome has helped to rapidly change the standard of care. Other targeted agents, such as anti-epidermal growth factor receptor (EGFR) antibodies, have shown proof of efficacy in colorectal cancer as well. The molecular targeted therapies are associated with toxicity profiles that are distinctly different from those seen with conventional chemotherapy. A notable difference is the absence of high risk for myelosuppression, diarrhea, or alopecia, which are common side effects of cytotoxic chemotherapy. This article will explore the toxicities associated with targeted therapies in detail in an attempt to provide assistance to the practicing oncologist in detecting and managing these side effects in their patients. In particular, the article will focus on the side effects associated with the three currently approved targeted drugs: the anti- VEGF monoclonal antibody bevacizumab and the anti-EGFR monoclonal antibodies cetuximab (Erbitux) and panitumumab (Vectibix).
随着生物制剂在结直肠癌治疗中疗效的证实，目前结直肠癌的传统治疗理念和治疗方案正在发生变化。在一线和二线治疗中，将抗血管内皮生长因子（VEGF）单克隆抗体贝伐单抗（阿瓦斯汀）添加到传统化疗中已显示出生存获益；这一结果有助于迅速改变治疗标准。其他靶向药物，如抗表皮生长因子受体（EGFR）抗体，在结直肠癌中也已显示出疗效证据。分子靶向治疗的毒性特征与传统化疗明显不同。一个显著的差异是不存在骨髓抑制、腹泻或脱发的高风险，而这些是细胞毒性化疗的常见副作用。本文将详细探讨与靶向治疗相关的毒性，试图为执业肿瘤学家在检测和管理其患者的这些副作用方面提供帮助。特别是，本文将重点关注与三种目前已获批的靶向药物相关的副作用：抗VEGF单克隆抗体贝伐单抗以及抗EGFR单克隆抗体西妥昔单抗（爱必妥）和帕尼单抗（维克替比）。
