肿瘤靶向药物治疗的疗效评价

Evaluation of response on tumor targeted therapy

靶向药物的出现是肿瘤治疗的一个重要进展。但是靶向药物的作用机制与传统的细胞毒药物不同,主要是干扰肿瘤的异常信号通道,导致肿瘤生长减慢,转移减少,或肿瘤坏死和空洞形成。因此,靶向药物的疗效评价较为复杂,无论是对于近期的客观疗效,还是临床研究的终点指标,以肿瘤大小为评价基础的实体瘤的疗效评价标准(RECIST)已经不能真实地反映药物的疗效。新的分子功能成像技术因为提供了生物信息,与RECIST标准结合,对靶向药物疗效的评估将会更为客观真实。

The development of targeted therapies is a major breakthough in the treatment of cancer. In contrast to traditionally cytotoxic agents, targeted therapies are designed to interfere with specific aberrant transduction pathway involved in tumorigenesis, slow the growth of tumors, limit the development of metastases, or evoke necrosis and cavitation. Therefore, the effect evaluation of the new targeted agents is more complex. The RECIST criteria by using tumor size are not sufficient for the evaluation of objective response, and are no longer suitable for setting of study endpoints. Molecular and functional imaging will provide realistic evaluation for targeted agents treatment response by incorporating biological information into RECIST criteria.