Gerber David E
Division of Hematology-Oncology, University of Texas Southwestern Medical Center, Dallas, Texas 75390-8852, USA.
Am Fam Physician. 2008 Feb 1;77(3):311-9.
Targeted therapies, which include monoclonal antibodies and small molecule inhibitors, have significantly changed the treatment of cancer over the past 10 years. These drugs are now a component of therapy for many common malignancies, including breast, colorectal, lung, and pancreatic cancers, as well as lymphoma, leukemia, and multiple myeloma. The mechanisms of action and toxicities of targeted therapies differ from those of traditional cytotoxic chemotherapy. Targeted therapies are generally better tolerated than traditional chemotherapy, but they are associated with several adverse effects, such as acneiform rash, cardiac dysfunction, thrombosis, hypertension, and proteinuria. Small molecule inhibitors are metabolized by cytochrome P450 enzymes and are subject to multiple drug interactions. Targeted therapy has raised new questions about the tailoring of cancer treatment to an individual patient's tumor, the assessment of drug effectiveness and toxicity, and the economics of cancer care. As more persons are diagnosed with cancer and as these patients live longer, primary care physicians will increasingly provide care for patients who have received targeted cancer therapy.
靶向治疗包括单克隆抗体和小分子抑制剂，在过去10年里显著改变了癌症的治疗方式。这些药物如今已成为许多常见恶性肿瘤治疗方案的一部分，包括乳腺癌、结直肠癌、肺癌和胰腺癌，以及淋巴瘤、白血病和多发性骨髓瘤。靶向治疗的作用机制和毒性与传统细胞毒性化疗不同。靶向治疗通常比传统化疗耐受性更好，但也会引发一些不良反应，如痤疮样皮疹、心脏功能障碍、血栓形成、高血压和蛋白尿。小分子抑制剂通过细胞色素P450酶代谢，会发生多种药物相互作用。靶向治疗在根据个体患者的肿瘤情况定制癌症治疗方案、评估药物有效性和毒性以及癌症治疗的经济学方面提出了新问题。随着越来越多的人被诊断出患有癌症且这些患者的寿命延长，初级保健医生将越来越多地为接受过癌症靶向治疗的患者提供护理。
