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非小细胞肺癌治疗药物研发的新见解。

New insights in drug development for the non-small cell lung cancer therapy.

作者信息

Gridelli Cesare, Rossi Antonio, Maione Paolo, Ferrara Carmine, Del Gaizo Filomena, Guerriero Ciro, Nicolella Dario, Palazzolo Giovanni, Falanga Marzia, Colantuoni Giuseppe

机构信息

Division of Medical Oncology, S.G. Moscati Hospital, Avellino, Italy.

出版信息

Front Biosci. 2008 May 1;13:5108-19. doi: 10.2741/3067.

Abstract

Non-small cell lung cancer (NSCLC) remains a major problem worldwide. Since most patients with NSCLC have advanced disease at diagnosis, to date, chemotherapy, with third-generation platinum-based doublets, represents the standard of care. However, a plateau has been reached with the use of cytotoxic chemotherapy in advanced NSCLC. Advances in the knowledge of tumour biology and mechanisms of oncogenesis have granted the singling out of several molecular targets for NSCLC treatment. To date, erlotinib and gefitinib, epidermal growth factor receptor tyrosine kinase (EGFR-TK) inhibitors have been licensed, erlotinib worldwide and gefitinib in Asian countries, for refractory NSCLC. Currently, bevacizumab, an anti-vascular endothelial growth factor (VEGF) monoclonal antibody, is the only clinically available antiangiogenic agent licensed, in combination with carboplatin plus paclitaxel, for first-line therapy of advanced NSCLC patients in the United States. Several new biologic agents are being evaluated in clinical research and some of them, such as ZD6474, sorafenib and sunitinib, due to the reported preliminary results and the oral administration seem to be promising targeted agents for the treatment of NSCLC. Aim of this review is to discuss about the new insights in targeted agents development for the treatment of NSCLC patients.

摘要

非小细胞肺癌(NSCLC)仍是全球范围内的一个主要问题。由于大多数NSCLC患者在确诊时已处于疾病晚期,迄今为止,以第三代铂类双联化疗方案为主的化疗是标准治疗方法。然而,晚期NSCLC使用细胞毒性化疗已达到一个平台期。肿瘤生物学和肿瘤发生机制知识的进展使得能够找出NSCLC治疗的几个分子靶点。迄今为止,表皮生长因子受体酪氨酸激酶(EGFR-TK)抑制剂厄洛替尼和吉非替尼已获许可,厄洛替尼在全球范围内,吉非替尼在亚洲国家用于难治性NSCLC。目前,抗血管内皮生长因子(VEGF)单克隆抗体贝伐单抗是唯一在美国被许可与卡铂加紫杉醇联合用于晚期NSCLC患者一线治疗的临床可用抗血管生成药物。几种新的生物制剂正在临床研究中进行评估,其中一些,如ZD6474、索拉非尼和舒尼替尼,由于报道的初步结果以及口服给药方式,似乎是治疗NSCLC有前景的靶向药物。本综述的目的是讨论NSCLC患者靶向药物研发的新见解。

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