Ruiz-Ceja Karla A, Chirino Yolanda I
Licenciatura en Biología, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, CP 54059, Estado de México, Mexico.
Laboratorio de Carcinogénesis y Toxicología, Unidad de Biomedicina, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, CP 54059, Estado de México, Mexico.
Biomed Pharmacother. 2017 Jun;90:24-37. doi: 10.1016/j.biopha.2017.03.018. Epub 2017 Mar 21.
Lung cancer is the leading worldwide cancer with almost 1.5 million deaths every year. Some drugs for lung cancer treatment have been available on the market for decades, but novel drugs have emerged promising better outcomes, especially for Non-Small Cell Lung Cancer (NSCLC), which represents 75% of lung cancer cases. However, how much do drugs have evolved for NSCLC treatment? Are they sharing the same mechanism of action?
In this review we analyzed how the approved drugs by Federal Drug Agency for NSCLC have advanced in the last four decades identifying shared mechanism of action of medicines against NSCLC treatment and some of the potential biomarkers for early detection.
Cisplatin and its derivatives are still the most used therapy in combination with some other more specific drugs. However, increasing the survival rates seems to be a great challenge and research is moving into early detection through biomarkers but also trying to identify molecules such as those derived from the immune system, cell-free DNA, non-coding RNAs, but also polymorphisms to detect early tumor formation.
Cisplatin and derivatives have been one of the most successful therapies in spite of their side effects and low specificity. Some of the drugs developed after cisplatin discovery, have been targeted the epidermal growth factor receptor, anaplastic lymphoma kinase, programmed cell death 1 ligand and vascular endothelial growth factor. Since none of the pharmacological treatments in combination with radiation/surgery have extended dramatically the survival rate, research is now focused in early cancer detection in combination with precision medicine, which attempts to treat patients individually according to their stage and tumor characteristics.
肺癌是全球主要的癌症，每年导致近150万人死亡。一些用于肺癌治疗的药物已在市场上销售数十年，但新型药物不断涌现，有望带来更好的治疗效果，尤其是对于占肺癌病例75%的非小细胞肺癌（NSCLC）。然而，NSCLC治疗药物的发展情况如何？它们的作用机制是否相同？
在本综述中，我们分析了美国食品药品监督管理局（FDA）批准的用于NSCLC的药物在过去四十年中的进展，确定了针对NSCLC治疗的药物的共同作用机制以及一些早期检测的潜在生物标志物。
顺铂及其衍生物仍然是与其他一些更具特异性的药物联合使用的最常用疗法。然而，提高生存率似乎是一项巨大的挑战，研究正在转向通过生物标志物进行早期检测，同时也试图识别诸如来自免疫系统、游离DNA、非编码RNA的分子，以及用于检测早期肿瘤形成的多态性。
尽管顺铂及其衍生物存在副作用且特异性较低，但它们一直是最成功的疗法之一。在顺铂发现后开发的一些药物已靶向表皮生长因子受体、间变性淋巴瘤激酶、程序性细胞死亡蛋白1配体和血管内皮生长因子。由于没有任何一种药物与放疗/手术联合使用能显著提高生存率，目前的研究重点是结合精准医学进行早期癌症检测，精准医学试图根据患者的分期和肿瘤特征对其进行个体化治疗。
