INSERM U955, Faculté de Médecine de Créteil 8 Rue du Général Sarrail, 94010, Créteil Cedex, France.
Cancer Med. 2013 Aug;2(4):421-6. doi: 10.1002/cam4.91. Epub 2013 May 28.
Cancers show considerable genetic and functional heterogeneity, preventing the development of a universal anticancer drug. Here, I argue that it is nevertheless possible to elaborate a therapeutic strategy that can be used in almost every cancer, exploiting the negative feedback effect of normal cells on the proliferation of their precursors. This method, termed cell inflation assisted chemotherapy, is aimed at blocking normal cell division prior to high-dose antimitotic chemotherapy. Evidence for a negative feedback effect on granulocyte production suggests that it is possible to prevent neutropenia by transfusion of autologous granulocytes. In a first step, this protocol will be devised to protect neutrophils and to prevent granulopenia in patients treated with intensive chemotherapy. In its simplest form, it will consist of a leukapheresis-storage-reinjection sequence just prior to drug administration. Then, if the proof of concept is established, a more systematic use of intensive cell cycle-specific chemotherapy, together with protection of other lineages through temporary mitotic blockade might be a treatment applicable for most cancers.
癌症表现出相当大的遗传和功能异质性，这使得开发一种通用的抗癌药物成为不可能。在这里，我认为，尽管如此，我们仍然可以制定一种治疗策略，可以在几乎所有癌症中使用，利用正常细胞对其前体细胞增殖的负反馈效应。这种方法被称为细胞膨胀辅助化疗，旨在在高剂量抗有丝分裂化疗之前阻断正常细胞分裂。粒细胞生成负反馈效应的证据表明，通过输注自体粒细胞有可能预防中性粒细胞减少症。在第一步中，该方案旨在保护接受强化化疗的患者的中性粒细胞并预防粒细胞减少症。最简单的形式是，在给药前进行白细胞分离-储存-再注入序列。然后，如果概念验证成立，更系统地使用密集的细胞周期特异性化疗，同时通过暂时的有丝分裂阻断来保护其他谱系，可能是一种适用于大多数癌症的治疗方法。
