Protein Engineering Unit, Life and Science Research Department, Anti-Doping Lab-Qatar (ADLQ), Doha, Qatar; Drug Design Group, Department of Pharmacy, University of Groningen, Groningen, Netherlands.
Drug Design Group, Department of Pharmacy, University of Groningen, Groningen, Netherlands.
Biomed Pharmacother. 2020 May;125:110009. doi: 10.1016/j.biopha.2020.110009. Epub 2020 Feb 25.
Until recently, patients who have the same type and stage of cancer all receive the same treatment. It has been established, however, that individuals with the same disease respond differently to the same therapy. Further, each tumor undergoes genetic changes that cause cancer to grow and metastasize. The changes that occur in one person's cancer may not occur in others with the same cancer type. These differences also lead to different responses to treatment. Precision medicine, also known as personalized medicine, is a strategy that allows the selection of a treatment based on the patient's genetic makeup. In the case of cancer, the treatment is tailored to take into account the genetic changes that may occur in an individual's tumor. Precision medicine, therefore, could be defined in terms of the targets involved in targeted therapy.
A literature search in electronic data bases using keywords "cancer targeted therapy, personalized medicine and cancer combination therapies" was conducted to include papers from 2010 to June 2019.
Recent developments in strategies of targeted cancer therapy were reported. Specifically, on the two types of targeted therapy; first, immune-based therapy such as the use of immune checkpoint inhibitors (ICIs), immune cytokines, tumor-targeted superantigens (TTS) and ligand targeted therapeutics (LTTs). The second strategy deals with enzyme/small molecules-based therapies, such as the use of a proteolysis targeting chimera (PROTAC), antibody-drug conjugates (ADC) and antibody-directed enzyme prodrug therapy (ADEPT). The precise targeting of the drug to the gene or protein under attack was also investigated, in other words, how precision medicine can be used to tailor treatments.
The conventional therapeutic paradigm for cancer and other diseases has focused on a single type of intervention for all patients. However, a large literature in oncology supports the therapeutic benefits of a precision medicine approach to therapy as well as combination therapies.
直到最近，患有相同类型和阶段癌症的患者都接受相同的治疗。然而，已经确定，患有相同疾病的个体对相同的治疗有不同的反应。此外，每个肿瘤都会发生导致癌症生长和转移的遗传变化。一个人癌症中发生的变化可能不会发生在具有相同癌症类型的其他人中。这些差异也导致对治疗的不同反应。精准医学，也称为个性化医学，是一种根据患者的基因构成选择治疗方法的策略。在癌症的情况下，治疗是根据个体肿瘤中可能发生的遗传变化量身定制的。因此，精准医学可以根据靶向治疗涉及的靶点来定义。
使用关键字“癌症靶向治疗、个性化医学和癌症联合治疗”在电子数据库中进行文献检索，以纳入 2010 年至 2019 年 6 月的论文。
报告了靶向癌症治疗策略的最新进展。具体来说，有两种类型的靶向治疗：第一，基于免疫的治疗，如使用免疫检查点抑制剂（ICIs）、免疫细胞因子、肿瘤靶向超抗原（TTS）和配体靶向治疗剂（LTTs）。第二种策略涉及酶/小分子为基础的治疗，如使用蛋白酶体靶向嵌合体（PROTAC）、抗体药物偶联物（ADC）和抗体定向酶前药治疗（ADEPT）。还研究了药物对受攻击的基因或蛋白质的精确靶向，换句话说，如何利用精准医学来定制治疗方法。
癌症和其他疾病的传统治疗模式一直侧重于对所有患者采用单一类型的干预措施。然而，肿瘤学领域的大量文献支持将精准医学方法和联合疗法应用于治疗的治疗益处。
