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癌症治疗中的新型RAF激酶抑制剂

New RAF kinase inhibitors in cancer therapy.

作者信息

Martin-Liberal Juan, Larkin James

机构信息

The Royal Marsden Hospital , Fulham Road SW3 6JJ, London , UK +44 20 7811 8576 ; +44 20 7811 8103 ;

出版信息

Expert Opin Pharmacother. 2014 Jun;15(9):1235-45. doi: 10.1517/14656566.2014.911286. Epub 2014 Apr 28.

DOI:10.1517/14656566.2014.911286
PMID:24766074
Abstract

INTRODUCTION

Alterations in some key components of the MAPK pathway, such as BRAF, have been found to be related to the development of several malignancies. A number of BRAF inhibitors have been developed in recent years. Two of these compounds, vemurafenib and dabrafenib, have been licensed for the treatment of BRAF-mutant advanced melanoma.

AREAS COVERED

This article reviews the antitumour activity and safety of the BRAF inhibitors, vemurafenib and dabrafenib. Moreover, early clinical data available for the most promising new members of this family of drugs as well as the novel therapeutic strategy of dual RAF-MEK inhibition is reviewed. A perspective of the potential role of MAPK inhibition in the treatment of cancer in forthcoming years is also provided.

EXPERT OPINION

Inhibition of BRAF has achieved highly successful results in patients affected by BRAF-mutated melanoma and has revolutionised their care. Its efficacy in other malignancies is currently under evaluation in monotherapy and as combination with other agents. Early clinical results of concomitant inhibition of BRAF and MEK suggest that this therapeutic approach is superior to either BRAF or MEK inhibition alone. Identification of BRAF mutations sensitive to treatment is essential for the success of these drugs.

摘要

引言

已发现丝裂原活化蛋白激酶(MAPK)通路的一些关键组分发生改变,如BRAF,与多种恶性肿瘤的发生发展相关。近年来已研发出多种BRAF抑制剂。其中两种化合物,维莫非尼和达拉非尼,已获许可用于治疗BRAF突变的晚期黑色素瘤。

涵盖领域

本文综述了BRAF抑制剂维莫非尼和达拉非尼的抗肿瘤活性及安全性。此外,还综述了该类药物中最具前景的新成员的早期临床数据以及双RAF-MEK抑制的新型治疗策略。同时也展望了未来几年MAPK抑制在癌症治疗中的潜在作用。

专家观点

BRAF抑制在BRAF突变的黑色素瘤患者中取得了非常成功的结果,并彻底改变了对他们的治疗方式。其在其他恶性肿瘤中的疗效目前正在单药治疗以及与其他药物联合治疗中进行评估。BRAF和MEK联合抑制的早期临床结果表明,这种治疗方法优于单独的BRAF或MEK抑制。识别对治疗敏感的BRAF突变对于这些药物的成功至关重要。

相似文献

1
New RAF kinase inhibitors in cancer therapy.癌症治疗中的新型RAF激酶抑制剂
Expert Opin Pharmacother. 2014 Jun;15(9):1235-45. doi: 10.1517/14656566.2014.911286. Epub 2014 Apr 28.
2
Vemurafenib for the treatment of BRAF mutant metastatic melanoma.维莫非尼用于治疗BRAF突变转移性黑色素瘤。
Future Oncol. 2015;11(4):579-89. doi: 10.2217/fon.14.252.
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Comparison of dabrafenib and trametinib combination therapy with vemurafenib monotherapy on health-related quality of life in patients with unresectable or metastatic cutaneous BRAF Val600-mutation-positive melanoma (COMBI-v): results of a phase 3, open-label, randomised trial.达拉非尼联合曲美替尼与维莫非尼单药治疗不可切除或转移性皮肤 BRAF Val600 突变阳性黑色素瘤患者的健康相关生活质量比较(COMBI-v):一项开放标签、随机、3 期临床试验结果。
Lancet Oncol. 2015 Oct;16(13):1389-98. doi: 10.1016/S1470-2045(15)00087-X.
4
BRAF and MEK inhibition for the treatment of advanced BRAF mutant melanoma.BRAF和MEK抑制用于治疗晚期BRAF突变型黑色素瘤。
Expert Opin Pharmacother. 2015 Jun;16(9):1285-97. doi: 10.1517/14656566.2015.1044971.
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Dabrafenib and its potential for the treatment of metastatic melanoma.达拉非尼及其治疗转移性黑色素瘤的潜力。
Drug Des Devel Ther. 2012;6:391-405. doi: 10.2147/DDDT.S38998. Epub 2012 Dec 11.
6
Long-term effects of BRAF inhibitors in melanoma treatment: friend or foe?BRAF抑制剂在黑色素瘤治疗中的长期影响:是友是敌?
Expert Opin Pharmacother. 2014 Apr;15(5):589-92. doi: 10.1517/14656566.2014.881471. Epub 2014 Jan 24.
7
Clinical development of dabrafenib in BRAF mutant melanoma and other malignancies.达拉非尼在 BRAF 突变型黑色素瘤和其他恶性肿瘤中的临床开发。
Expert Opin Drug Metab Toxicol. 2013 Jul;9(7):893-9. doi: 10.1517/17425255.2013.794220. Epub 2013 Apr 29.
8
Dabrafenib therapy for advanced melanoma.达拉非尼治疗晚期黑色素瘤。
Ann Pharmacother. 2014 Apr;48(4):519-29. doi: 10.1177/1060028013513009. Epub 2013 Nov 20.
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Paradoxical oncogenesis: are all BRAF inhibitors equal?矛盾的致癌作用:所有 BRAF 抑制剂都一样吗?
Pigment Cell Melanoma Res. 2013 Sep;26(5):611-5. doi: 10.1111/pcmr.12132. Epub 2013 Jul 19.
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Controversies in the management of advanced melanoma: "gray" areas amid the "black and blue".晚期黑色素瘤治疗中的争议:“青一块紫一块”中的“灰色地带”
Ann Pharmacother. 2014 Nov;48(11):1456-68. doi: 10.1177/1060028014544165. Epub 2014 Jul 23.

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FAM83 proteins: Fostering new interactions to drive oncogenic signaling and therapeutic resistance.FAM83蛋白:促进新的相互作用以驱动致癌信号传导和治疗抗性。
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Discovery of RAF265: A Potent mut-B-RAF Inhibitor for the Treatment of Metastatic Melanoma.RAF265的发现:一种用于治疗转移性黑色素瘤的强效突变型B-RAF抑制剂。
ACS Med Chem Lett. 2015 Aug 3;6(9):961-5. doi: 10.1021/ml500526p. eCollection 2015 Sep 10.