Cézé Nicolas, Lecomte Thierry, Watier Hervé
CHRU de Tours, service d'hépato-gastroentérologie et d'oncologie digestive (NC, TL) et Laboratoire d'immunologie (HW), Tours, France.
Med Sci (Paris). 2009 Dec;25(12):1099-104. doi: 10.1051/medsci/200925121099.
The development of therapeutic monoclonal antibodies (mAb) provided many great advances in the treatment of some diseases, in particular cancers. In the treatment of cancers, tumour angiogenesis inhibition by mAb occupies a major place. Tumour angiogenesis is a highly complex multifactor process in which many molecules, which originate both in the tumor cells or their environment, display pro- or anti-angiogenic functions. Many molecular pathways, among which those triggered by vascular endothelial growth factor, platelet-derived growth factor and integrins, are currently under investigation in therapeutic anti-angiogenesis research. Bevacizumab is to date the only mAb targeting the tumour vasculature that is currently used in clinical practice. Clinical trials have revealed its efficacy in colorectal, breast, kidney and lung cancers and gliobastoma multiforme. Such a success confirms the effectiveness in the treatment of cancer of using mAb inhibiting tumour angiogenesis, and many mAb targeting different angiogenesis pathways will probably be developed. Beyond clinical oncology, angiogenesis inhibition by mAb is of increasing interest in many other fields of medicine. It could offer interesting therapeutic strategies in some cardiovascular or rheumatologic diseases and currently represents the standard cure in some blinding ocular disorders.
治疗性单克隆抗体（mAb）的发展在某些疾病，尤其是癌症的治疗方面带来了许多重大进展。在癌症治疗中，单克隆抗体抑制肿瘤血管生成占据了重要地位。肿瘤血管生成是一个高度复杂的多因素过程，其中许多源自肿瘤细胞或其周围环境的分子具有促血管生成或抗血管生成功能。目前，治疗性抗血管生成研究正在调查许多分子途径，其中由血管内皮生长因子、血小板衍生生长因子和整合素触发的途径。贝伐单抗是迄今为止临床实践中唯一用于靶向肿瘤血管系统的单克隆抗体。临床试验已揭示其在结直肠癌、乳腺癌、肾癌、肺癌和多形性胶质母细胞瘤中的疗效。这一成功证实了使用抑制肿瘤血管生成的单克隆抗体治疗癌症的有效性，并且可能会开发出许多靶向不同血管生成途径的单克隆抗体。除了临床肿瘤学，单克隆抗体抑制血管生成在许多其他医学领域也越来越受到关注。它可能在某些心血管或风湿性疾病中提供有趣的治疗策略，目前在一些致盲性眼部疾病中代表标准治疗方法。
