Mavani Heena J, Wick Jeannette Y
Consult Pharm. 2016 Dec 1;31(12):676-684. doi: 10.4140/TCP.n.2016.676.
In 2016, the American health care system was faced with more than 1.6 million new cases of cancer, and individuals older than 65 years of age will be affected disproportionately. Many older individuals are poor candidates for traditional treatments (e.g., chemotherapy, radiation) because of actual or potential treatment-related adverse events. Researchers continuously look for novel therapeutic strategies, and an exciting new one is on the horizon: virotherapy. Viruses' ability to infect and kill human cells makes them promising cancer treatments. The greatest success has been seen in acute lymphocytic leukemia. To date, four genetically engineered oncolytic viruses have been approved globally by several countries' health regulatory agencies, but several challenges remain. Only one, talimogene laherparepvec (T-Vec), is available in the United States. Treatment-naive patients tend to respond better than patients receiving T-Vec as second-line therapy. Other good candidates for T-Vec include elderly patients who do not tolerate checkpoint inhibitors (the leading immunotherapy in advanced melanoma). Researchers continue to look for ways to increase oncolytic viruses' clinical potency. Once they do, these agents will become effective cancer therapy.
GM-CSF = Genetically modified colony-stimulating factor, HIV = Human immunodeficiency virus, HSV-1 = Herpes simplex virus, OV = Oncolytic virus.
2016年，美国医疗保健系统面临超过160万例新发癌症病例，65岁以上的个体将受到不成比例的影响。由于实际或潜在的与治疗相关的不良事件，许多老年个体并非传统治疗（如化疗、放疗）的理想人选。研究人员不断寻找新的治疗策略，一种令人兴奋的新策略即将出现：病毒疗法。病毒感染和杀死人类细胞的能力使其成为有前景的癌症治疗方法。在急性淋巴细胞白血病中已取得了最大的成功。迄今为止，四种基因工程溶瘤病毒已在全球范围内获得多个国家卫生监管机构的批准，但仍存在一些挑战。在美国只有一种，即talimogene laherparepvec（T-Vec）可用。未接受过治疗的患者往往比接受T-Vec二线治疗的患者反应更好。T-Vec的其他理想人选包括不耐受检查点抑制剂（晚期黑色素瘤的主要免疫疗法）的老年患者。研究人员继续寻找提高溶瘤病毒临床效力的方法。一旦找到，这些药物将成为有效的癌症治疗方法。
GM-CSF = 基因改造的集落刺激因子，HIV = 人类免疫缺陷病毒，HSV-1 = 单纯疱疹病毒，OV = 溶瘤病毒
