Lai G G Y, Penson R T
Division of Hematology Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Drugs Today (Barc). 2011 Sep;47(9):669-81. doi: 10.1358/dot.2011.47.9.1673557.
Epithelial ovarian cancer is the most lethal of gynecologic malignancies in the United States, with a significant proportion of patients with advanced disease achieving clinical remission with conventional treatment approaches, but dying of recurrence. Bevacizumab is a first-in-class antiangiogenic. This recombinant humanized monoclonal antibody neutralizes vascular endothelial growth factor (VEGF) and inhibits endothelial and tumor cell activation and proliferation. It has a low clearance and long elimination half-life, supporting a convenient 2- or 3-weekly dosing schedule. It is generally well tolerated, although trials have highlighted some toxicity-related concerns, notably gastrointestinal perforation. Phase III trials that evaluate overall survival are not yet mature, and cost-effectiveness of bevacizumab is hotly debated. As more evidence for the role of anti-VEGF agents in augmenting therapy and inducing durable tumor dormancy continues to emerge, it is anticipated that antiangiogenic therapy will play an important role in the management ovarian malignancy.
上皮性卵巢癌是美国最致命的妇科恶性肿瘤，相当一部分晚期疾病患者通过传统治疗方法实现临床缓解，但最终死于复发。贝伐单抗是一流的抗血管生成药物。这种重组人源化单克隆抗体可中和血管内皮生长因子（VEGF），并抑制内皮细胞和肿瘤细胞的活化与增殖。它清除率低，消除半衰期长，支持方便的每2周或3周给药方案。尽管试验突出了一些与毒性相关的问题，尤其是胃肠道穿孔，但它总体耐受性良好。评估总生存期的III期试验尚未成熟，贝伐单抗的成本效益也备受争议。随着越来越多关于抗VEGF药物在增强治疗和诱导持久肿瘤休眠中作用的证据不断出现，预计抗血管生成治疗将在卵巢恶性肿瘤的管理中发挥重要作用。
