Nor Hisam Nur Syahidah, Ugusman Azizah, Rajab Nor Fadilah, Ahmad Mohd Faizal, Fenech Michael, Liew Sze Ling, Mohamad Anuar Nur Najmi
Programme of Biomedical Science, Centre for Toxicology & Health Risk Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia.
Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia.
Pharmaceutics. 2021 Aug 28;13(9):1353. doi: 10.3390/pharmaceutics13091353.
Combination therapy emerges as a fundamental scheme in cancer. Many targeted therapeutic agents are developed to be used with chemotherapy or radiation therapy to enhance drug efficacy and reduce toxicity effects. ABT-263, known as navitoclax, mimics the BH3-only proteins of the BCL-2 family and has a high affinity towards pro-survival BCL-2 family proteins (i.e., BCL-XL, BCL-2, BCL-W) to induce cell apoptosis effectively. A single navitoclax action potently ameliorates several tumor progressions, including blood and bone marrow cancer, as well as small cell lung carcinoma. Not only that, but navitoclax alone also therapeutically affects fibrotic disease. Nevertheless, outcomes from the clinical trial of a single navitoclax agent in patients with advanced and relapsed small cell lung cancer demonstrated a limited anti-cancer activity. This brings accumulating evidence of navitoclax to be used concomitantly with other chemotherapeutic agents in several solid and non-solid tumors that are therapeutically benefiting from navitoclax treatment in preclinical studies. Initially, we justify the anti-cancer role of navitoclax in combination therapy. Then, we evaluate the current evidence of navitoclax in combination with the chemotherapeutic agents comprehensively to indicate the primary regulator of this combination strategy in order to produce a therapeutic effect.
联合治疗已成为癌症治疗的基本方案。许多靶向治疗药物被开发出来与化疗或放疗联合使用,以提高药物疗效并降低毒性作用。ABT-263,即维托克拉,模拟BCL-2家族中仅含BH3结构域的蛋白质,对促生存BCL-2家族蛋白(即BCL-XL、BCL-2、BCL-W)具有高亲和力,可有效诱导细胞凋亡。单独使用维托克拉可有效改善多种肿瘤进展,包括血液和骨髓癌以及小细胞肺癌。不仅如此,单独使用维托克拉还对纤维化疾病有治疗作用。然而,在晚期和复发小细胞肺癌患者中进行的维托克拉单药临床试验结果显示其抗癌活性有限。这使得越来越多的证据表明,在一些实体瘤和非实体瘤中,维托克拉可与其他化疗药物联合使用,这些肿瘤在临床前研究中从维托克拉治疗中获益。首先,我们阐述维托克拉在联合治疗中的抗癌作用。然后,我们全面评估维托克拉与化疗药物联合使用的现有证据,以指出这种联合策略的主要调节因素,从而产生治疗效果。