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高级别胶质瘤中表皮生长因子受体的治疗性抑制:我们目前的进展如何?

Therapeutic inhibition of the epidermal growth factor receptor in high-grade gliomas: where do we stand?

作者信息

Karpel-Massler Georg, Schmidt Ursula, Unterberg Andreas, Halatsch Marc-Eric

机构信息

Neurochirurgische Klinik und Poliklinik, Heidelberg, Germany.

出版信息

Mol Cancer Res. 2009 Jul;7(7):1000-12. doi: 10.1158/1541-7786.MCR-08-0479. Epub 2009 Jul 7.

Abstract

High-grade gliomas account for the majority of intra-axial brain tumors. Despite abundant therapeutic efforts, clinical outcome is still poor. Thus, new therapeutic approaches are intensely being investigated. Overexpression of the epidermal growth factor receptor (HER1/EGFR) is found in various epithelial tumors and represents one of the most common molecular abnormalities seen in high-grade gliomas. Dysregulated HER1/EGFR is found in 40% to 50% of glioblastoma, the most malignant subtype of glioma. Several agents such as tyrosine kinase (TK) inhibitors, antibodies, radio-immuno conjugates, ligand-toxin conjugates, or RNA-based agents have been developed to target HER1/EGFR or its mutant form, EGFRvIII. To date, most agents are in various stages of clinical development. Clinical data are sparse but most advanced for TK inhibitors. Although data from experimental studies seem promising, proof of a significant clinical benefit is still missing. Among the problems that have to be further addressed is the prediction of the individual patient's response to HER1/EGFR-targeted therapeutics based on molecular determinants. It is quite possible that blocking HER1/EGFR alone will not sufficiently translate into a clinical benefit. Therefore, a multiple target approach concomitantly aimed at different molecular sites might be a favorable concept. This review focuses on current HER1/EGFR-targeted therapeutics and their development for high-grade gliomas.

摘要

高级别胶质瘤占脑内肿瘤的大多数。尽管进行了大量治疗努力,但临床结果仍然很差。因此,正在深入研究新的治疗方法。表皮生长因子受体(HER1/EGFR)的过表达在各种上皮肿瘤中均有发现,并且是高级别胶质瘤中最常见的分子异常之一。在40%至50%的胶质母细胞瘤(胶质瘤最恶性的亚型)中发现HER1/EGFR失调。已经开发了几种药物,如酪氨酸激酶(TK)抑制剂、抗体、放射免疫缀合物、配体-毒素缀合物或基于RNA的药物,以靶向HER1/EGFR或其突变形式EGFRvIII。迄今为止,大多数药物正处于临床开发的不同阶段。临床数据稀少,但TK抑制剂的数据最为先进。尽管实验研究的数据似乎很有前景,但仍缺乏显著临床获益的证据。必须进一步解决的问题之一是基于分子决定因素预测个体患者对HER1/EGFR靶向治疗的反应。仅阻断HER1/EGFR很可能不足以转化为临床获益。因此,同时针对不同分子位点的多靶点方法可能是一个有利的概念。本综述重点关注目前针对HER1/EGFR的治疗方法及其在高级别胶质瘤中的开发。

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