Sharkey Robert M, Goldenberg David M
Garden State Cancer Center, Center for Molecular Medicine and Immunology, Belleville, NJ 07109, USA.
Adv Drug Deliv Rev. 2008 Sep;60(12):1407-20. doi: 10.1016/j.addr.2008.04.011. Epub 2008 Apr 24.
There are currently 6 unconjugated antibodies and 3 immunoconjugates approved for use in the United States in a variety of cancers, with a considerable number of new agents in clinical testing and preclinical development. Unconjugated antibodies alone can be effective, but more often, antibodies need to be combined with chemotherapy, which enhances the efficacy of the standard treatment. Immunoconjugates tend to be more effective than their unconjugated counterparts, but their increased toxicity often restricts when and how they are used. In order to improve efficacy, a number of immunoconjugates are being examined in settings where the disease is more easily accessible, such as leukemias, or within compartments that allow easier and more direct access to the tumor, such as in the peritoneal cavity or brain, or both locally and systemically, in adjuvant situations, where the disease burden has been reduced by some other means, and with the main goal of these treatments being to kill residual disease.
目前在美国有6种未偶联抗体和3种免疫偶联物被批准用于多种癌症的治疗,还有相当数量的新药正处于临床试验和临床前开发阶段。单独使用未偶联抗体可能有效,但更多时候,抗体需要与化疗联合使用,以增强标准治疗的疗效。免疫偶联物往往比未偶联的同类药物更有效,但其毒性增加常常限制了它们的使用时间和方式。为了提高疗效,正在对一些免疫偶联物进行研究,研究场景包括疾病更容易触及的情况,如白血病,或在更容易且更直接触及肿瘤的腔隙内,如腹膜腔或脑内,或在局部和全身范围内,在辅助治疗中,此时疾病负担已通过其他手段减轻,而这些治疗的主要目标是杀死残留疾病。