Filipits M
Institute of Cancer Research, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
J BUON. 2009 Sep;14 Suppl 1:S147-52.
Targeted therapies with monoclonal antibodies have been shown to improve the outcome of non-small cell lung cancer (NSCLC). Current strategies focus on the blockade of growth factor receptors and the inhibition of angiogenesis. Epidermal growth factor receptor (EGFR)-directed monoclonal antibodies in combination with platinum-based first-line chemotherapy have shown promising efficacy in phase II trials. In a phase III trial, cetuximab combined with cisplatin/ vinorelbine resulted in superior survival compared to chemotherapy alone in patients with advanced EGFR-positive NSCLC. Inhibition of angiogenesis has also been successfully applied as a new treatment strategy. Bevacizumab added to palliative chemotherapy has improved progression-free survival in two phase III trials and overall survival in one of these trials in selected patients with advanced non-squamous cell lung cancer. Bevacizumab is now approved for selected patients with advanced NSCLC in combination with platinum-based chemotherapy. Figitumumab is a monoclonal antibody against the insulin-like growth factor-1 receptor (IGF-1R) which demonstrated activity in preclinical models of NSCLC and in a phase II trial. Because of these promising results, three randomized, open-label, international phase III trials of figitumumab in patients with locally advanced or metastatic NSCLC are in progress.
单克隆抗体靶向治疗已被证明可改善非小细胞肺癌（NSCLC）的治疗效果。当前策略聚焦于阻断生长因子受体和抑制血管生成。表皮生长因子受体（EGFR）导向的单克隆抗体联合铂类一线化疗在II期试验中显示出有前景的疗效。在一项III期试验中，与单纯化疗相比，西妥昔单抗联合顺铂/长春瑞滨使晚期EGFR阳性NSCLC患者的生存期更长。抑制血管生成也已成功作为一种新的治疗策略应用。在两项III期试验中，贝伐单抗加入姑息化疗改善了无进展生存期，在其中一项试验中，对于选定的晚期非鳞状细胞肺癌患者，还改善了总生存期。贝伐单抗现被批准用于选定的晚期NSCLC患者，联合铂类化疗。Figitumumab是一种抗胰岛素样生长因子-1受体（IGF-1R）的单克隆抗体，在NSCLC临床前模型和一项II期试验中显示出活性。鉴于这些有前景的结果，三项关于Figitumumab用于局部晚期或转移性NSCLC患者的随机、开放标签、国际III期试验正在进行。
