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转移性实体瘤的维持治疗:创新策略还是简单的二线治疗?

Maintenance Therapy in Metastatic Solid Tumors: Innovative Strategy or Simple Second-line Treatment?

机构信息

Departments of Medical Oncology.

Radiotherapy, Lucien Neuwirth Cancer Institute, St Priest en Jarez, France.

出版信息

Am J Clin Oncol. 2019 Aug;42(8):615-623. doi: 10.1097/COC.0000000000000574.

Abstract

Managing metastatic diseases involves defining the best strategy that is supposed to take into account both efficacy and quality of life. To this end, clinicians use stop and go or maintenance strategies. As a matter of fact, 2 maintenance strategies can be distinguished: continuation maintenance using a drug already present in induction treatment and switch maintenance with a newly introduced drug. Several drugs have been approved as maintenance therapy with several current indications in solid tumors. Questions remain concerning such strategies, notably duration, cost, tolerability, and shortcut between switch maintenance and early second line. If the concept of maintenance strategy remains trendy with numerous trials ongoing, several issues are still pending. The aims of this review were to accurately define and describe the various facets of maintenance therapy through its several indications in real life and then to discuss the future challenges of maintenance therapy in oncology.

摘要

管理转移性疾病需要确定最佳策略,该策略应同时考虑疗效和生活质量。为此,临床医生使用停止和继续或维持策略。实际上,可以区分 2 种维持策略:使用诱导治疗中已有的药物进行继续维持治疗和使用新引入的药物进行转换维持治疗。有几种药物已被批准作为维持治疗,在实体瘤中有几个适应证。这些策略仍存在一些问题,如持续时间、成本、耐受性,以及转换维持治疗和早期二线治疗之间的捷径。虽然维持策略的概念仍然很流行,并且有许多试验正在进行,但仍有几个问题悬而未决。本综述的目的是通过其在现实生活中的多种适应证,准确地定义和描述维持治疗的各个方面,然后讨论肿瘤学中维持治疗的未来挑战。

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