所有抗血管生成药物在二线转移性结直肠癌治疗中都一样吗？临床实践专家意见
Are All Anti-Angiogenic Drugs the Same in the Treatment of Second-Line Metastatic Colorectal Cancer? Expert Opinion on Clinical Practice.
作者信息
Lai Eleonora, Cascinu Stefano, Scartozzi Mario
机构信息
Medical Oncology Unit, University Hospital and University of Cagliari, Cagliari, Italy.
Oncologia Medica, Università Vita-Salute, IRCCS Ospedale San Raffaele, Milano, Italy.
出版信息
Front Oncol. 2021 May 10;11:637823. doi: 10.3389/fonc.2021.637823. eCollection 2021.
Abstract
Targeting tumor-driven angiogenesis is an effective strategy in the management of metastatic colorectal cancer (mCRC); however, the choice of second-line therapy is complicated by the availability of several drugs, the occurrence of resistance and the lack of validated prognostic and predictive biomarkers. This review examines the use of angiogenesis-targeted therapies for the second-line management of mCRC patients. Mechanisms of resistance and anti-placental growth factor agents are discussed, and the role of aflibercept, a recombinant fusion protein consisting of portions of human vascular endothelial growth factor receptor (VEGFR)-1 and VEGFR-2, is highlighted. The novel mechanism of action of aflibercept makes it a useful second-line agent in mCRC patients progressing after oxaliplatin-based chemotherapy, as well as in those with resistance after bevacizumab.
摘要
靶向肿瘤驱动的血管生成是转移性结直肠癌（mCRC）治疗中的一种有效策略；然而，二线治疗的选择因多种药物的可及性、耐药性的出现以及缺乏经过验证的预后和预测生物标志物而变得复杂。本综述探讨了血管生成靶向疗法在mCRC患者二线治疗中的应用。讨论了耐药机制和抗胎盘生长因子药物，并强调了阿柏西普（一种由人血管内皮生长因子受体（VEGFR）-1和VEGFR-2部分组成的重组融合蛋白）的作用。阿柏西普的新型作用机制使其成为在基于奥沙利铂的化疗后进展的mCRC患者以及贝伐单抗治疗后耐药患者中的一种有用的二线药物。
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