分子靶抗癌药:伊丽沙治疗非小细胞肺癌的临床效益

<title>e molecularly targeted anticancer agent: The clinical benefit of iressa in the treatment of non-small-cell lung cancer

伊丽沙(iressa,gefitinib,ZD1839)是新一类的靶向抗癌药。本文综述一种具有口服活性、选择性的表皮生长因子受体--酪氨酸激酶抑制剂(EGFR-TKI)--Iressa治疗晚期非小细胞肺癌(NSCLC)的作用。本品对人类多种肿瘤,包括NSCLC细胞株和移植物有强大的抑制作用。不良反应250mg/d组<500mg/d组。所有经治疗无效的NSCLC患者应用本品(250mg/d),疾病控制率>40％,与临床试验一致。本品与常规化疗或放疗联合应用的可能性研究也正在进行。

<abstract>essa (gefitinib ZD1839) is one member of new class of targeted anticancer agent. This article reviews the role of an orally active, selective drug of the epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)--Iressa in the treatment of patients of non-small-cell lung cancer (NSCLC). This agent hasshown potent activity in a number of tumour, including NSCLC cell lines and xenografts. The multi-institutional , large randomized trial suggest that oral iressa at 250 or 500mg/d provides clinically significant antitumor activity, accompanied by rapid clinically meaningful symptom relief (about 50% of pts) and improvements in QOL as second (objective response in about 19% of pts) and third-line (objective response in about 10% of pts) treatment in patients with advaneed NSCLC who have received previous platinum-based therapy. The 250mg/d dose of iressa has more favorable safety profile and better toterbility than the 500mg/d dose. Iressa monotherapy (250mg/d) was made available on a compassionate-use basis to patients with advanced NSCLC who had no other treatment options. The overall disease control rate is > 40% , which is consistent with the findings of clinical trials. The effects of combining this agent with conventional chemotherapy or radiotherapy are also under investigation. These should be designed to assess novel combination and schedules, determine whether this agent can play a role in early stage disease or even in neoadjuvant/ adjuvant chemotherapy.