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小分子激酶抑制剂在胶质母细胞瘤中的应用:临床研究的系统评价。

Small molecule kinase inhibitors in glioblastoma: a systematic review of clinical studies.

机构信息

Neurosurgical Center Amsterdam, VU University Medical Center, De Boelelaan 1117, Amsterdam, The Netherlands.

出版信息

Neuro Oncol. 2010 Mar;12(3):304-16. doi: 10.1093/neuonc/nop068. Epub 2010 Feb 9.

Abstract

The efficacy of small-molecule kinase inhibitors has recently changed standard clinical practice for several solid cancers. Glioblastoma is a solid cancer that universally recurs and unrelentingly results in death despite maximal surgery and radiotherapy with concomitant and adjuvant temozolomide. Several clinical studies using kinase inhibitors in glioblastoma have been reported. The present study systematically reviews the efficacy, toxicity, and tissue analysis of small-molecule kinase inhibitors in adult patients with glioblastoma as reported in published clinical studies and determines which kinases have been targeted by the inhibitors used in these studies. Publications were retrieved using a MEDLINE search and by screening meeting abstracts. A total of 60 studies qualified for inclusion, of which 25 were original reports. A total of 2385 glioblastoma patients receiving kinase inhibitors could be evaluated. The study designs included 2 phase III studies and 37 phase II studies. Extracted data included radiological response, progression-free survival, overall survival, toxicity, and biomarker analysis. The main findings were that (i) efficacy of small-molecule kinase inhibitors in clinical studies with glioblastoma patients does not yet warrant a change in standard clinical practice and (ii) 6 main kinase targets for inhibitors have been evaluated in these studies: EGFR, mTOR, KDR, FLT1, PKCbeta, and PDGFR.

摘要

小分子激酶抑制剂最近改变了几种实体瘤的标准临床实践。胶质母细胞瘤是一种实体瘤,尽管进行了最大限度的手术和放射治疗,并同时和辅助使用替莫唑胺,但普遍复发且无情地导致死亡。已经报道了几项使用激酶抑制剂治疗胶质母细胞瘤的临床研究。本研究系统地综述了已发表的临床研究中报告的小分子激酶抑制剂在成人胶质母细胞瘤患者中的疗效、毒性和组织分析,并确定了这些研究中使用的抑制剂针对哪些激酶。使用 MEDLINE 搜索和筛选会议摘要检索出版物。共有 60 项研究符合纳入标准,其中 25 项为原始报告。共评估了 2385 名接受激酶抑制剂治疗的胶质母细胞瘤患者。研究设计包括 2 项 III 期研究和 37 项 II 期研究。提取的数据包括影像学反应、无进展生存期、总生存期、毒性和生物标志物分析。主要发现是:(i)小分子激酶抑制剂在胶质母细胞瘤患者的临床研究中的疗效尚不能改变标准的临床实践;(ii)这些研究评估了 6 种主要的激酶抑制剂靶点:EGFR、mTOR、KDR、FLT1、PKCβ和 PDGFR。

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