Said Rabih, Tsimberidou Apostolia Maria
The University of Texas MD Anderson Cancer Center, Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program) , 1515 Holcombe Blvd., Unit 455, Houston, TX 77030-3722 , USA +1 713 792 4259 ; +1 713 794 3249 ;
Expert Opin Drug Metab Toxicol. 2014 Mar;10(3):483-94. doi: 10.1517/17425255.2014.885016. Epub 2014 Feb 10.
Vincristine is a key agent for the treatment of acute lymphoblastic leukemia (ALL) and other lymphoid malignancies. The strong antineoplastic activity of vincristine has been limited by its pharmacological characteristics.
This paper reviews the role of vincristine in the treatment of lymphoid malignancies. This review summarizes its efficacy and toxicity, and focuses on the pharmacokinetic features of vincristine that affect clinical outcomes.
As a single agent, vincristine is associated with brief and incomplete responses, but in combination with other agents, vincristine has dramatically improved the outcomes of lymphoid malignancies such as ALL. Vincristine is a key drug of hyper-fractionated cyclophosphamide, vincristine, doxorubicin and dexamethasone, an intensive chemotherapeutic regimen for the treatment of ALL, and of cyclophosphamid, adriamycin, vincristine and prednisone, which has been used extensively in the treatment of patients with aggressive or indolent lymphomas and Richter syndrome. The strong antileukemic activity of vincristine has been limited by its variable and unpredictable pharmacological characteristics, narrow therapeutic index and neurotoxicity profile. These characteristics prompted the development of liposomal vincristine, which has optimized its clinical application. Liposomal vincristine has promising antileukemic activity, and it is approved by the FDA as a single agent for the treatment of relapsed/refractory Philadelphia chromosome-negative ALL.
长春新碱是治疗急性淋巴细胞白血病（ALL）和其他淋巴系统恶性肿瘤的关键药物。长春新碱强大的抗肿瘤活性受到其药理学特性的限制。
本文综述了长春新碱在淋巴系统恶性肿瘤治疗中的作用。本综述总结了其疗效和毒性，并重点关注影响临床结果的长春新碱药代动力学特征。
作为单一药物，长春新碱的反应短暂且不完全，但与其他药物联合使用时，长春新碱显著改善了ALL等淋巴系统恶性肿瘤的治疗结果。长春新碱是超分割环磷酰胺、长春新碱、阿霉素和地塞米松（一种用于治疗ALL的强化化疗方案）以及环磷酰胺、阿霉素、长春新碱和泼尼松（已广泛用于治疗侵袭性或惰性淋巴瘤及 Richter 综合征患者）中的关键药物。长春新碱强大的抗白血病活性受到其可变且不可预测的药理学特性、狭窄的治疗指数和神经毒性特征的限制。这些特性促使了脂质体长春新碱的研发，优化了其临床应用。脂质体长春新碱具有有前景的抗白血病活性，并且已被美国食品药品监督管理局（FDA）批准作为单一药物用于治疗复发/难治性费城染色体阴性ALL。
