卡培他滨治疗结直肠癌的毒效标志物的研究进展

Research progress on toxicity and prognostic markers of capecitabine in treatment of colorectal cancer

结直肠癌是临床较常见的恶性肿瘤之一,给社会带来沉重的负担。卡培他滨是口服氟尿嘧啶类前体药物,用于多种恶性肿瘤的化疗。化疗中,原发性和继发性耐药仍然较为普遍,且个体差异大,因剂量限制性毒性而导致的延迟给药和降低剂量,影响了生存预后。当前,随着精准医疗的发展,许多卡培他滨毒效和疗效的标志物被发现。近年来有关卡培他滨治疗结直肠癌的毒效标志物主要有临床病理指标、代谢酶表达、基因多态、表观遗传学和代谢组学的预测指标。分析表明单一指标的预测准确度不高,而联合各类预测指标建立的模型有可能显著提高毒效预测的准确度。

Colorectal cancer is one of the most common malignant tumors in clinical,which brings heavy burden to society.Capecitabine is an oral pro-drug of 5-fluorouracil,which is used in the treatment of various malignancy.Primary and secondary drug resistance is still common in the chemotherapy,and the inter-individual difference is great.Delayed remedy and reduced dose caused by dose-limiting toxicity affected prognosis.The recent studies of toxicity and prognostic markers of capecitabine in treatment of colorectal cancer are mainly from clinicopathological index,metabolic enzyme expression,gene polymorphism,epigenetics,and metabolomics.The analysis shows that the accuracy of single marker is not high,and the model established by combining various predictive markers may significantly improve the accuracy of toxicity and prognostic prediction.