Françoso Alex, Simioni Patricia Ucelli
Department of Biomedical Science, Faculty of Americana, Americana.
Department of Biomedical Science, Faculty of Americana, Americana; Department of Genetics, Evolution and Bioagents, Institute of Biology, University of Campinas, Campinas; Department of Biochemistry and Microbiology, Institute of Biosciences, Universidade Estadual Paulista, Rio Claro, São Paulo, Brazil.
Drug Des Devel Ther. 2017 Jan 11;11:177-184. doi: 10.2147/DDDT.S119036. eCollection 2017.
Colorectal cancer is considered a disease of the elderly population. Since the number of geriatric patients continues to rise, monoclonal antibody therapy is the most promising therapy in the recent research. Presently, the monoclonal antibodies most frequently used in the treatment of colorectal tumors are bevacizumab, cetuximab, panitumumab, and ramucirumab. Bevacizumab is a monoclonal antibody that acts on VEGF. Cetuximab and panitumumab act on EGFR. Ramucirumab binds directly to the ligand-binding pocket of VEGFR-2 to block the binding of VEGF-A, VEGF-C, and VEGF-D. These monoclonal antibodies, alone or in association with radiotherapy or chemotherapy, are presenting good results and are increasing patient survival, despite the side effects. Due to the limited number of molecules available, several studies are trying to develop new monoclonal antibodies for the treatment of colorectal tumors. Among those being studied, some recent molecules are in phase I and/or II trials and are yielding advantageous results, such as anti-DR5, anti-Fn14, anti-IGF-1R, anti-EGFR, anti-NRP1, and anti-A33 antibodies. This has been successful in reducing side effects and in treating nonresponsive patients.
结直肠癌被认为是一种老年人群的疾病。由于老年患者数量持续增加，单克隆抗体疗法是近期研究中最具前景的治疗方法。目前，治疗结直肠肿瘤最常用的单克隆抗体是贝伐单抗、西妥昔单抗、帕尼单抗和雷莫西尤单抗。贝伐单抗是一种作用于血管内皮生长因子（VEGF）的单克隆抗体。西妥昔单抗和帕尼单抗作用于表皮生长因子受体（EGFR）。雷莫西尤单抗直接结合血管内皮生长因子受体-2（VEGFR-2）的配体结合口袋，以阻断血管内皮生长因子-A（VEGF-A）、血管内皮生长因子-C（VEGF-C）和血管内皮生长因子-D（VEGF-D）的结合。尽管存在副作用，但这些单克隆抗体单独使用或与放疗或化疗联合使用时，都呈现出良好的效果，并提高了患者的生存率。由于可用分子数量有限，多项研究正在尝试开发用于治疗结直肠肿瘤的新单克隆抗体。在正在研究的抗体中，一些近期的分子正处于I期和/或II期试验，并取得了有利的结果，如抗死亡受体5（anti-DR5）、抗成纤维细胞生长因子诱导14（anti-Fn14）、抗胰岛素样生长因子1受体（anti-IGF-1R）、抗表皮生长因子受体（anti-EGFR）、抗神经纤毛蛋白1（anti-NRP1）和抗A33抗体。这在减少副作用和治疗无反应患者方面取得了成功。
