Teicher Beverly A
Genzyme Corporation, 49 New York Avenue, Framingham, MA 01701-9322, USA.
Toxicol Pathol. 2009 Jan;37(1):114-22. doi: 10.1177/0192623308329473. Epub 2008 Dec 19.
Predicting whether a potential new anticancer agent will have a positive therapeutic index in patients remains a challenge. This brief review provides examples of preclinical in vivo/ex vivo and in situ assays used to assess the therapeutic potential of experimental anticancer therapeutics. Excision assays involving removal of tumor, bone marrow, and other tissues from the host after treatment to determine the effects of therapy in ex vivo assays are important preclinical tools. The survival of malignant cells from tumors treated in vivo and then excised is often determined by colony formation (CFU) in culture. When mice bearing in vivo alkylating agent-resistant tumors were treated with anticancer drugs such as cyclophosphamide, the survival pattern of bone marrow granulocyte-macrophage-colony forming units (CFU-GM) paralleled tumor cell survival. When TNP-470 and minocycline, an antiangiogenic combination, were added to treatment with cytotoxic anticancer therapies, tumor response markedly increased. TNP-470/minocycline-treated mice had higher tissue drug levels than did mice treated with the drug alone. Enzastaurin, an antiangiogenic protein kinase Cbeta inhibitor, treatment decreased intratumoral vessels to one half to one quarter of controls. Simultaneous and sequential treatment regimens with enzastaurin and BCNU delayed tumor growth and increased lifespan in mice bearing subcutaneous or intracranial human T98G glioblastoma multiforme. Both TNP-470 and enzastaurin have undergone clinical trials. Enzastaurin is currently in Phase III clinical trials.
预测一种潜在的新型抗癌药物在患者中是否会有积极的治疗指数仍然是一项挑战。这篇简短的综述提供了用于评估实验性抗癌疗法治疗潜力的临床前体内/体外和原位检测的实例。切除检测,即在治疗后从宿主中切除肿瘤、骨髓和其他组织以确定治疗在体外检测中的效果,是重要的临床前工具。体内治疗后切除的肿瘤中恶性细胞的存活情况通常通过培养中的集落形成(CFU)来确定。当用环磷酰胺等抗癌药物治疗体内携带对烷化剂耐药肿瘤的小鼠时,骨髓粒细胞-巨噬细胞集落形成单位(CFU-GM)的存活模式与肿瘤细胞存活情况平行。当将抗血管生成组合TNP-470和米诺环素添加到细胞毒性抗癌疗法治疗中时,肿瘤反应显著增加。接受TNP-470/米诺环素治疗的小鼠组织药物水平高于单独接受该药物治疗的小鼠。恩杂鲁胺,一种抗血管生成的蛋白激酶Cβ抑制剂,治疗可使肿瘤内血管减少至对照组的二分之一至四分之一。恩杂鲁胺与卡莫司汀同时和序贯治疗方案可延迟荷皮下或颅内人多形性胶质母细胞瘤T98G小鼠的肿瘤生长并延长其寿命。TNP-470和恩杂鲁胺都已进行了临床试验。恩杂鲁胺目前处于III期临床试验阶段。