Fuchs H, Bachran C
Zentralinstitut für Laboratoriumsmedizin und Pathobiochemie, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
Curr Drug Targets. 2009 Feb;10(2):89-93. doi: 10.2174/138945009787354557.
Conventional tumor therapy is usually based on surgery, radiation and chemotherapy. Treatment with chemotherapeutics is often impeded by dose-limiting toxicities. Therefore, medical scientists sought for tools to improve chemotherapy by directly coupling targeting molecules to cytotoxic substances. This review provides a general overview on the development of targeted drugs designed for tumor therapy. Further carrier-based delivery systems of anti-tumorigenic drugs will not be described here. The targeting moiety is usually an antibody or a fragment thereof. Growth factors, cytokines and ligands are also used as targeting moiety. The targeting moiety is coupled to the toxic moiety either chemically or both components were combined as fusion proteins. In addition to those targeted molecules containing conventional chemotherapeutics, more sophisticated targeted drugs were developed containing protein toxins, such as diphtheria toxin or Pseudomonas exotoxin. Only a small number of these protein toxins inside tumor cells results in efficient killing of the target cell. Several of these targeted toxins are currently in clinical trials. Another targeting mechanism utilizes the activation of formerly harmless substances in the vicinity of tumor cells. This mechanism is referred to as directed enzyme prodrug therapy.
传统的肿瘤治疗通常基于手术、放疗和化疗。化疗药物的治疗常常受到剂量限制毒性的阻碍。因此,医学科学家们寻求通过将靶向分子直接与细胞毒性物质偶联来改进化疗的工具。本综述对用于肿瘤治疗的靶向药物的发展进行了概述。此处不再描述基于载体的抗肿瘤药物递送系统。靶向部分通常是抗体或其片段。生长因子、细胞因子和配体也用作靶向部分。靶向部分通过化学方法与毒性部分偶联,或者将两个组分作为融合蛋白结合在一起。除了那些含有传统化疗药物的靶向分子外,还开发了更复杂的靶向药物,其中含有蛋白质毒素,如白喉毒素或铜绿假单胞菌外毒素。肿瘤细胞内仅少量的这些蛋白质毒素就能有效杀死靶细胞。目前有几种这类靶向毒素正在进行临床试验。另一种靶向机制利用肿瘤细胞附近原本无害的物质的激活。这种机制被称为定向酶前药疗法。