School of Life Science and Food Engineering, Huaiyin Institute of Technology, Huaian 223003, China.
School of Biomedical Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China.
Int J Biol Macromol. 2021 Jan 31;168:22-37. doi: 10.1016/j.ijbiomac.2020.12.009. Epub 2020 Dec 5.
Cancer is one of the leading causes of death with a mortality rate of 12%. Although significant progress has been achieved in cancer research, the effective treatment of cancer remains the greatest global challenge in medicine. Dysregulation of tyrosine kinases (TK) is one of the characteristics of several types of cancers. Thus, drugs that target and inhibit these enzymes, known as TK inhibitors (TKIs), are considered vital chemotherapeutics to combat various types of cancer. The oral bioavailability of available TKIs and their targeted therapy are their potential benefits. Based on these characteristics, most TKIs are included in first/second-line therapy for the treatment of different cancers. This review aims to shed light on orally-active TKIs (natural and synthetic molecules) and their promising implication in the therapy of numerous types of tumors along with their mechanisms of action. Further, recent progress in the development of synthetic and isolation of natural TKIs is reviewed. A significant growth in research regarding the development of new-generation TKIs is made with time (23 FDA-approved TKIs from 2018) due to their better therapeutic response. Oral bioavailability should be considered as an important parameter while developing of new-generation TKIs; however, drug delivery systems can also be used to address issue of poor bioavailability to a certain extent. Moreover, clinical trials should be designed in consideration of the development of resistance and tumor heterogeneity.
癌症是导致死亡的主要原因之一,死亡率为 12%。尽管癌症研究取得了重大进展,但癌症的有效治疗仍然是医学领域最大的全球挑战。酪氨酸激酶(TK)的失调是几种类型癌症的特征之一。因此,靶向和抑制这些酶的药物,即酪氨酸激酶抑制剂(TKIs),被认为是对抗各种类型癌症的重要化疗药物。现有 TKIs 的口服生物利用度及其靶向治疗是其潜在的益处。基于这些特性,大多数 TKIs 被纳入不同癌症的一线/二线治疗。本综述旨在阐明口服活性 TKIs(天然和合成分子)及其在治疗多种肿瘤中的潜在作用及其作用机制。此外,还回顾了近年来合成和分离天然 TKIs 的进展。由于新一代 TKIs 的治疗反应更好,随着时间的推移(2018 年有 23 种获得 FDA 批准的 TKIs),针对新一代 TKIs 的开发的研究有了显著增长。在开发新一代 TKIs 时,应将口服生物利用度视为一个重要参数;然而,药物传递系统也可以在一定程度上解决生物利用度差的问题。此外,临床试验的设计应考虑到耐药性和肿瘤异质性的发展。