Neuroscience Research, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 46285, USA.
Curr Pharm Biotechnol. 2011 Oct;12(10):1627-43. doi: 10.2174/138920111798357267.
Most cancer patients will experience moderate to severe pain and/or neuropathy during the course of their disease. Recent improvements in the primary treatment of cancer have increased the life span of cancer patients, but not necessarily their quality of life (QoL). The pain and suffering cancer patients experience may be the result of the tumor itself, or the treatments required to arrest tumor growth and progression. In contrast to the rapid, highly mechanistic, tailored medicine approach used to target and treat the primary tumor burden, the evolution of pain and other supportive treatment approaches for cancer patients have been slow to non-existent. A movement is emerging to use more rational mechanistic approaches to the treatment of pain created by cancer and chemotherapeutics. This review briefly describes the most severe and debilitating symptoms (endophenotypes) from the cancer patient's perspective, the biochemical/neurobiological sequalae associated with tumor growth and therapies designed to arrest tumor progression, and highlights some promising pharmacologic mechanisms that may be used to treat cancer-related pain, sensory neuropathies, and associated endophenotypes. Delivering improved broader spectrum supportive care medicines to cancer patients will fill a significant unmet need and enable them to live productive, fulfilling lives that preserve their overall QoL.
大多数癌症患者在疾病过程中会经历中度到重度的疼痛和/或神经病变。癌症的主要治疗方法最近有所改进，提高了癌症患者的寿命，但不一定提高了他们的生活质量（QoL）。癌症患者所经历的疼痛和痛苦可能是肿瘤本身的结果，也可能是为了阻止肿瘤生长和进展而需要进行的治疗。与用于靶向和治疗原发性肿瘤负担的快速、高度机械、定制药物方法不同，针对癌症患者的疼痛和其他支持性治疗方法的发展缓慢甚至不存在。一种利用更合理的机械机制来治疗癌症和化疗药物引起的疼痛的运动正在兴起。本文简要描述了癌症患者最严重和使人衰弱的症状（内表型）、与肿瘤生长和旨在阻止肿瘤进展的治疗相关的生化/神经生物学后果，并重点介绍了一些有希望的药理学机制，这些机制可能用于治疗与癌症相关的疼痛、感觉神经病变和相关的内表型。为癌症患者提供改善的广谱支持性护理药物将满足重大未满足的需求，使他们能够过上富有成效、充实的生活，保持他们的整体生活质量。
