Department of Medicine, Roswell Park Cancer Institute, Buffalo, New York, USA.
CA Cancer J Clin. 2013 Jul-Aug;63(4):249-79. doi: 10.3322/caac.21184. Epub 2013 May 28.
Answer questions and earn CME/CNE Advances in genomics and molecular biology have identified aberrant proteins in cancer cells that are attractive targets for cancer therapy. Because these proteins are overexpressed or dysregulated in cancer cells compared with normal cells, it was assumed that their inhibitors will be narrowly targeted and relatively nontoxic. However, this hope has not been achieved. Current targeted agents exhibit the same frequency and severity of toxicities as traditional cytotoxic agents, with the main difference being the nature of the toxic effects. Thus, the classical chemotherapy toxicities of alopecia, myelosuppression, mucositis, nausea, and vomiting have been generally replaced by vascular, dermatologic, endocrine, coagulation, immunologic, ocular, and pulmonary toxicities. These toxicities need to be recognized, prevented, and optimally managed.
在基因组学和分子生物学方面的进展已经确定了癌细胞中异常的蛋白质，这些蛋白质是癌症治疗的有吸引力的靶点。由于这些蛋白质在癌细胞中的表达过度或失调，与正常细胞相比，人们认为它们的抑制剂将具有更窄的靶向性和相对较低的毒性。然而，这种期望并未实现。目前的靶向药物表现出与传统细胞毒性药物相同的频率和严重程度的毒性，主要区别在于毒性作用的性质。因此，经典的化疗毒性，如脱发、骨髓抑制、黏膜炎、恶心和呕吐，已被血管、皮肤、内分泌、凝血、免疫、眼部和肺部毒性所取代。这些毒性需要被识别、预防，并进行最佳管理。
