Kelley Robin, Venook Alan P
University of California, San Francisco, 1600 Divisadero Street, Box 1705, San Francisco, CA 94115, USA.
Curr Oncol Rep. 2009 May;11(3):175-85. doi: 10.1007/s11912-009-0026-2.
Despite recent advances in treatment options, advanced colorectal cancer (ACC) remains a leading cause of cancer death worldwide, and new therapies are needed to improve the grim prognosis of this disease. Drug development in ACC faces the challenges of a constrained pipeline, a paucity of patients enrolled in clinical trials, and an outdated "one drug fits all" model of clinical research. This article discusses potential innovations in clinical trial design--including enrichment strategies, novel patient populations, and the use of randomization in the phase 2 setting--to optimize the testing of new therapies. It concludes with a selection of promising agents and pathways under investigation in ACC.
尽管近期治疗方案取得了进展，但晚期结直肠癌（ACC）仍是全球癌症死亡的主要原因之一，因此需要新的疗法来改善这种疾病严峻的预后。ACC的药物研发面临着研发渠道受限、参与临床试验的患者数量不足以及过时的“一刀切”临床研究模式等挑战。本文讨论了临床试验设计中的潜在创新——包括富集策略、新型患者群体以及在2期试验中使用随机化——以优化新疗法的测试。文章最后还介绍了一些在ACC中正在研究的有前景的药物和途径。
