Jakobovits A
Agensys Inc., 1545 17th Street, Santa Monica, CA 90404, USA.
Handb Exp Pharmacol. 2008(181):237-56. doi: 10.1007/978-3-540-73259-4_11.
Early detection of prostate cancer (PCa) and advances in hormonal and chemotherapy treatments have provided great clinical benefits to patients with early stages of the disease. However, a significant proportion of patients still progress to advanced, metastatic disease, for which no effective therapies are available. Therefore, there is a critical need for new treatment modalities, ideally targeted specifically to prostate cancer cells. The recent clinical and commercial successes of monoclonal antibodies (MAbs) have made them the most rapidly expanding class of therapeutics being developed for many disease indications, including cancer. PCa is well suited for antibody-based therapy due to the size and location of recurrent and metastatic tumors, and the lack of necessity to avoid targeting the normal prostate, a nonessential organ. These properties have fostered interest in the development and clinical evaluation of therapeutic MAbs directed to both well established and newly discovered targets in PCa. MAbs directed to established targets include those approved for other solid tumors, including anti-human epidermal growth factor receptor-2 (HER2) MAb trastuzumab, anti-epidermal growth factor receptor (EGFR) MAbs cetuximab and panitumumab, and the antivascular endothelial growth factor (VEGF) MAb bevacizumab. Genomics efforts have yielded a large number of novel, clinically relevant targets in PCa with the desirable expression profiling in tumor and normal tissues, and with an implicated role in tumor growth and spread. Growing efforts are directed to the development of naked or payload-conjugated therapeutic antibodies to these targets, and a variety of MAb products are currently progressing through preclinical and various stages of clinical development. The clinical experience with some of the commercialized MAb products points out specific challenges in conducting clinical trials with targeted therapy in PCa.
前列腺癌(PCa)的早期检测以及激素和化疗治疗的进展为疾病早期患者带来了巨大的临床益处。然而,仍有相当一部分患者会进展为晚期转移性疾病,对此尚无有效的治疗方法。因此,迫切需要新的治疗方式,理想情况下是专门针对前列腺癌细胞的治疗方式。单克隆抗体(MAb)最近在临床和商业上的成功使其成为针对包括癌症在内的许多疾病适应症开发的治疗药物中增长最快的一类。由于复发性和转移性肿瘤的大小和位置,以及无需避免靶向正常前列腺(一个非必需器官),PCa非常适合基于抗体的治疗。这些特性激发了人们对开发和临床评估针对PCa中已确立和新发现靶点的治疗性单克隆抗体的兴趣。针对已确立靶点的单克隆抗体包括那些已被批准用于其他实体瘤的抗体,如抗人表皮生长因子受体2(HER2)单克隆抗体曲妥珠单抗、抗表皮生长因子受体(EGFR)单克隆抗体西妥昔单抗和帕尼单抗,以及抗血管内皮生长因子(VEGF)单克隆抗体贝伐单抗。基因组学研究在PCa中产生了大量新的、具有临床相关性的靶点,这些靶点在肿瘤和正常组织中具有理想的表达谱,并且在肿瘤生长和扩散中具有潜在作用。人们越来越致力于开发针对这些靶点的裸抗体或负载缀合治疗性抗体,目前有多种单克隆抗体产品正处于临床前和临床开发的各个阶段。一些商业化单克隆抗体产品的临床经验指出了在PCa中进行靶向治疗临床试验的具体挑战。