Horn Leora, Sandler Alan B
Vanderbilt Ingram Cancer Center, Vanderbilt University, Nashville, TN 32323-6307, USA.
Proc Am Thorac Soc. 2009 Apr 15;6(2):206-17. doi: 10.1513/pats.200807-066LC.
Lung cancer is the leading cause of cancer-related mortality in the United States. Patients with advanced disease have a median survival of approximately 10 months when treated with standard platinum-based therapy. Improvements in our understanding of cancer biology have led to the development of novel agents that more precisely affect the target of interest, allowing for a more rational approach to clinical trial design. Angiogenesis, the growth of new vessels from pre-existing vessels, is a fundamental step in tumor growth and progression. Inhibition of tumor-related angiogenesis has become an attractive target for anticancer therapy. A large randomized trial demonstrated an improvement in overall survival when bevacizumab, a monoclonal antibody against vascular endothelial growth factor (VEGF), was combined with chemotherapy in patients with advanced non-small cell lung cancer (NSCLC). Small molecule inhibitors targeting both the VEGF receptor (VEGFR) and the tyrosine kinase receptor have also shown promise when combined with standard chemotherapy, but their role in the treatment of patients with NSCLC remains to be determined. This paper reviews clinical trials that have incorporated antiangiogenic agents in the treatment of patients with NSCLC.
肺癌是美国癌症相关死亡的主要原因。晚期疾病患者接受标准铂类治疗时的中位生存期约为10个月。我们对癌症生物学理解的进步导致了新型药物的开发，这些药物能更精确地作用于目标靶点，从而使临床试验设计更具合理性。血管生成，即从已有的血管生长出新的血管，是肿瘤生长和进展的一个基本步骤。抑制肿瘤相关血管生成已成为抗癌治疗的一个有吸引力的靶点。一项大型随机试验表明，在晚期非小细胞肺癌（NSCLC）患者中，抗血管内皮生长因子（VEGF）单克隆抗体贝伐单抗与化疗联合使用时，总生存期有所改善。靶向VEGF受体（VEGFR）和酪氨酸激酶受体的小分子抑制剂与标准化疗联合使用时也显示出前景，但它们在NSCLC患者治疗中的作用仍有待确定。本文综述了将抗血管生成药物纳入NSCLC患者治疗的临床试验。
