Harousseau J L
Service d'hématologie clinique, Hôtel-Dieu, CHU de Nantes, 1, place Alexis-Ricordeau, 44035 Nantes.
Bull Cancer. 1998 Dec;85(12):993-6.
Biological response modifiers (BRM) are a new approach of cancer treatment. The guidelines for their evaluation are comparable to those used for evaluating conventional anticancer treatments. However, it is more difficult to assess their efficacy and toxicity because of their own properties and of the characteristics of underlying diseases. The objectives of studying BRM efficacy are the following : 1- to confirm the pharmacodynamic effect observed in experimental models; 2- to assess the benefit for the patient. Phase II studies can occasionally be performed in healthy volunteers. Efficacy criteria are objective response rate, progression free survival, overall survival or, for hematopoietic growth factors, more specific criteria. In randomized phase III studies patients in the control arm can be observed without treatment, or receive a placebo or a standard treatment. As regards toxicity, side effects specifically related to the use of BRM are the synthesis of cytokines, the stimulation of immune system, the stimulation of tumor growth, the synthesis of anti-mouse of anti-BRM antibodies.
生物反应调节剂(BRM)是一种癌症治疗的新方法。评估它们的指南与用于评估传统抗癌治疗的指南类似。然而,由于其自身特性和基础疾病的特点,评估它们的疗效和毒性更加困难。研究BRM疗效的目标如下:1-确认在实验模型中观察到的药效学效应;2-评估对患者的益处。II期研究偶尔可在健康志愿者中进行。疗效标准是客观缓解率、无进展生存期、总生存期,或者对于造血生长因子而言,是更具体的标准。在随机III期研究中,对照组的患者可以不接受治疗,或者接受安慰剂或标准治疗。关于毒性,与使用BRM特别相关的副作用是细胞因子的合成、免疫系统的刺激、肿瘤生长的刺激、抗BRM抗体的抗小鼠合成。