Kumar Shiyam, Masood Nehal, Adil Salman Naseem
Section of Hematology/Oncology, Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan.
J Pak Med Assoc. 2009 Aug;59(8):555-61.
In last two decades newer therapies in cancer treatment have emerged and have opened new horizons. New term of targeted therapy has emerged and for certain malignancies the paradigm has really changed after the introduction of these agents. We have learnt and have seen the outcome of some diseases after the addition of these monoclonal antibodies (MoABs) and tyrosine kinase inhibitors (TKIs). Rituximab a MoAB against CD-20 has really paved its role in the treatment of B-cell lymphomas and become the sort of standard therapy. The TKIs are newer agents available in a pill form and have inhibited many pathways at cellular level which are necessary for cancer development. Imatinib has really changed the prognosis and outcome of chronic myeloid leukemia (CML) remarkably. For those patients who develope intolerance to imatinib or their disease became resistant to the imatinib the newer agents like dasatinib and nilotinib are second line options. The major edge of these newer agents is more potency with low side-effect profile. The major concern remains the cost.
在过去二十年中，癌症治疗领域出现了更新的疗法，开辟了新的视野。“靶向治疗”这一新术语应运而生，对于某些恶性肿瘤而言，这些药物的引入确实改变了治疗模式。在添加这些单克隆抗体（MoABs）和酪氨酸激酶抑制剂（TKIs）之后，我们了解并见证了一些疾病的治疗结果。抗CD - 20的单克隆抗体利妥昔单抗在B细胞淋巴瘤的治疗中发挥了重要作用，并成为了一种标准疗法。TKIs是新型的片剂形式药物，它们在细胞水平上抑制了许多癌症发展所必需的途径。伊马替尼显著改变了慢性粒细胞白血病（CML）的预后和治疗结果。对于那些对伊马替尼不耐受或疾病对伊马替尼耐药的患者，达沙替尼和尼洛替尼等新型药物是二线选择。这些新型药物的主要优势在于药效更强且副作用较小。主要问题仍然是成本。
