脑胶质瘤的抗肿瘤血管生成治疗新进展

综述了脑胶质瘤的血管生成新理念及与VEGF、bFGF等因子的关系 ,叙述了抗血管生成治疗的新策略、新途径。它必将是治疗胶质瘤的一条新路 ,但仍有不少问题。     

脑胶质瘤分子病因及其靶向治疗的研究进展

脑胶质瘤是常见的脑内恶性肿瘤,是目前中枢神经系统疾病的重点和难点。以手术治疗为主的包括放射治疗、化学治疗、免疫治疗和中医药等在内的综合治疗措施是目前治疗的共识。即使是神经影像学等检查技术的发展和术中肿瘤视踪技术的应用,显微手术治疗仍很难保证肿瘤切除后的周围“正常”组织中无肿瘤细胞。临床上应用的分子靶向治疗在其他肿瘤中取得了较大的进展,而对脑胶质瘤的靶向治疗尚在研究之中。本次研究对脑胶质瘤的分子病因和相关的分子靶向治疗药物作一综述．     

脑胶质瘤治疗现状与进展

胶质瘤是最常见的颅内原发恶性肿瘤,目前的标准治疗方法包括手术切除和放化疗并不能带来满意的治疗效果,这与胶质瘤在脑内的侵袭性生长、血脑屏障限制和肿瘤耐药相关.近年来,随着肿瘤基因组和免疫微环境等研究的深入,分子病理已引入临床指导胶质瘤的分子分型、预后评估和个体化治疗,也有越来越多的分子治疗新靶点被发现.同时,免疫治疗和肿...     

分子靶向疗法及其药物在恶性胶质瘤治疗中的应用

恶性胶质瘤是成年人最好发的中枢神经系统恶性肿瘤,随着对肿瘤分子机制理解的深入,提出了分子靶向疗法。这一针对恶性肿瘤的新疗法,可以改善肿瘤患者的治疗效果,同时降低药物毒性。分子靶向治疗属于肿瘤的生物治疗范畴,其原理主要是针对恶性肿瘤细胞与正常组织细胞之间的差异,使抗肿瘤药物特异地杀伤肿瘤细胞,而对正常组织细胞影响较小,从而提高患者生存质量、延长生存时间。     

肿瘤分子靶向治疗进展

随着分子靶向药物的研发和临床使用，肿瘤的分子靶向治疗已成为肿瘤内科治疗的研究热点。现有的研究结果已表明肿瘤分子靶向治疗具有较好的安全性和一定的有效性，尤其以针对表皮生长因子受体（EGFR）和血管内皮生长因子（VEGF）靶点的药物。小分子EGFR酪氨酸激酶抑制剂、抗EGFR单克隆抗体、抗VEGF单克隆抗体以及其他分子靶向治疗药物，已在临床中取得较好的疗效。但疗效的预测、怎样与传统治疗方法配合以提高疗效及分子靶向药物的耐药性等问题仍有待解决。     

原发性肝癌的分子靶向治疗

原发性肝癌的传统化疗药物治疗毒性较大,且不敏感,临床应用效果较差。近年来,分子靶向治疗在恶性肿瘤治疗方面取得较大的进展,如格列卫(Glivec)治疗胃肠道间质瘤,依瑞沙(Iressa)治疗非小细胞肺癌。同样,分子靶向治疗在肝癌的治疗方面也取得了一些进展。如酪氨酸激酶抑制剂、新生血管生成抑制剂、单克隆抗体和基因治疗等方面~[1]。本文就肝癌分子靶向治疗的进展作一综述。     

药物靶向、分子靶向、激素靶向及干细胞靶向与骨质疏松症的治疗

背景:骨质疏松症引起的骨折及其他并发症严重影响中老年人生活质量。目的:探讨靶向疗法治疗骨质疏松的进展,以促进其临床应用。方法:由第一作者应用计算机检索PubMed、中国期刊全文数据库(CNKI)中1997-05/2011-12相关文献。在标题、摘要、关键词中以"targeted therapy,bone target,stem cell,osteoporosis,treatment"或"靶向治疗,骨靶向,干细胞,骨质疏松,治疗"为检索词进行检索。选择文章内容与靶向疗法治疗骨质疏松有关者,同一领域则选择近期发表在权威杂志上的文章。结果与结论:初检得到148篇文献,根据纳入标准选择38篇文献进行综述。靶向治疗骨质疏松已成为骨质疏松治疗中的研究热点。目前研究领域涉及药物靶向、分子靶向、激素靶向、受体靶向及干细胞靶向治疗等,其中药物、分子及激素靶向疗法为目前常用的治疗方法,常用药物有四环素、双膦酸盐类、Denosumab等。但目前靶向治疗骨质疏松尚未完全成熟,所导致的临床不良反应限制其应用进展,仍有许多问题有待解决。     

肿瘤基因检测与分子靶向治疗

近年来,随着肿瘤相关基础研究进展和一些技术方法的成熟和应用,如分子遗传、信号转导、生物信息学、蛋白质组学、基因组学、DNA重组、杂交瘤技术和生物芯片技术等,肿瘤分子靶向治疗进展迅速。自1997年11月美国食品药物管理局(FDA)批准利妥昔单抗用于非霍奇金淋巴瘤的靶向治疗以来,     

抗肿瘤血管生成靶向药物不良反应机制与处理进展

血管生成在恶性肿瘤的发生发展以及转移的过程中发挥着重要作用,在肿瘤的分子靶向治疗中抗血管生成已成为重要的治疗手段.目前临床中常用的抗血管生成药物包括单克隆抗体类(代表药物贝伐单抗)、酪氨酸激酶抑制剂类(代表药物索拉菲尼、舒尼替尼)以及内皮细胞生长抑制剂等.不同类别的抗肿瘤血管生成靶向药物其不良反应各不相同,掌握该类药物的不良反应发生机制以及相关不良反应的处理措施,对接受该类药物治疗患者的耐受性会得到提高,同时也使患者预后得到进一步改善.     

血管内皮抑制素靶向抑制恶性脑胶质瘤的研究

恶性脑胶质瘤是成人中最常见的原发性恶性脑瘤,约占颅内肿瘤的33．3—58．9％,平均43．5％,具有侵袭性,其血管丰富,可无限制增生,缺乏凋亡,复发率居颅内肿瘤首位,被认为是神经外科治疗中最棘手的难治性肿瘤之一。神经胶质瘤（Giiomas）亦称胶质细胞瘤,简称胶质瘤,是发生于神经外胚层的肿瘤,故亦称神经外胚层肿瘤或神经上皮肿瘤。一般都称为神经胶质瘤。神经胶质瘤的病程依其病理类型和所在部位长短不一,自出现症状至就诊时间一般多为数周至数月,少数可达数年。恶性程度高的和后颅窝肿瘤病史多较短,     

Molecular targeted therapy for breast cancer treatment, challenge to cure

Clinical outcome of breast cancer patients has been improved by development of molecular target agents such as trastuzumab and lapatinib. However, it is still difficult to "cure" all the patients. In order to improve the results, understanding the mechanisms of action and resistance is crucial. Detection of accurate predictive markers of response to these therapies are also required. Various new drugs and their combinations are being challenged in the (pre)clinical trial along this strategy. In this review, we summarize the current findings in target therapy for breast cancer patients.     

进展期胃癌的分子靶向治疗

过去的二十年里,进展期胃癌患者通过治疗后可以改善生活质量及延长生存期,但是其治疗方法并没有获得显著进展。虽然胃癌的中位生存期大约在7~11个月,且存活超过2年的已经〉10%,但是,对于进展期胃癌患者来说,其最合适的一线化疗方案一直存在争议,且大多数人对化疗仍持有偏见。最近,肿瘤生物学的显著进展促进了靶向致癌关键途径的新药物研究。在国际随机研究中,对进展期胃癌来说,多数分子靶向因子被证实有效,一种抗HER-2单克隆抗体（曲妥珠单抗）显示在抗HER-2阳性的进展期胃癌方面有抗肿瘤活性。然而,只有20%的HER-2阳性的进展期胃癌患者在此获益。因此,发展更有效的因子和鉴别预测及预后的标记物因子来选择哪些患者能从特定的化疗方案和靶向治疗中获益显得至关重要。本文就进展期胃癌的靶向治疗作一综述。     

Lessons learned in the development of targeted therapy for malignant gliomas

The prognosis of patients with glioblastoma, anaplastic astrocytoma, and anaplastic oligodendroglioma remains poor despite standard treatment with radiotherapy and temozolomide. Molecular targeted therapy holds the promise of providing new, more effective treatment options with minimal toxicity. However, the development of targeted therapy for gliomas has been particularly challenging. The oncogenetic process in such tumors is driven by several signaling pathways that are differentially activated or silenced with both parallel and converging complex interactions. Therefore, it has been difficult to identify prevalent targets that act as key promoters of oncogenesis and that can be successfully addressed by novel agents. Several drugs have been tested, including epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (gefitinib and erlotinib), mammalian target of rapamycin (mTOR) inhibitors (temsirolimus and everolimus), and vascular endothelial growth factor receptor (VEGFR), protein kinase C-beta, and other angiogenesis pathways inhibitors (vatalanib, bevacizumab, and enzastaurin). Although preliminary efficacy results of most trials in recurrent disease have fallen short on expectations, substantial advances have been achieved by associated translational research. In this article, we seek to recapitulate the lessons learned in the development of targeted therapy for gliomas, including challenges and pitfalls in the interpretation of preclinical data, specific issues in glioma trial design, insights provided by translational research, changes in paradigms, and future perspectives.     

Molecular targeted therapy in lung cancer

Lung cancer continues to be the leading cause of cancer death worldwide, and nonsmall cell lung cancer(NSCLC) is the most common type of lung cancer. Despite many clinical trials of platinum-based chemotherapy in combination with various drugs, the median survival time of NSCLC patients remains poor. The overall 5-year survival rate is approximately 15%, and has improved only marginally over the last few decades despite the introduction of new therapeutic agents. A recent milestone in this field has been the development of molecular-targeting drugs, among which gefitinib and erlotinib targeting the epidermal growth factor receptor (EGFR) have improved the efficacy of therapy for NSCLC. Anti-angiogenetic drug, such as bevacizumab, had become clinical use in the treatment for NSCLC. Moreover, discovery of EML4-ALK made the marvelous progress in cancer research in NSCLC. In this review, we discuss about the development of molecular-targeting drugs, such as EGFR-TKI, anti-angiogenetic drug, and EMLA-ALK inhibitors.     

Combined targeted therapy and immunotherapy for cancer treatment

Although targeted therapies and immunotherapies have been effective against several malignancies, the respective monotherapies are limited by low and/or short-term responses. Specific inhibitors of oncogenic signaling pathways and tumor-associated angiogenesis can activate the anti-tumor immune responses by increasing tumor antigen presentation or intratumor T cell infiltration. Additional insights into the effects and mechanisms of targeted therapies on the induction of anti-tumor immunity will facilitate development of rational and effective combination strategies that synergize rapid tumor regression and durable response. In this review, we have summarized the recent combinations of targeted therapies and immunotherapies, along with the associated clinical challenges.     

Molecular targeted therapy in Alzheimer disease

Alzheimer disease(AD) is the most common cause of dementia in the elderly. However, the availability of effective disease-modifying drugs for AD is currently limited. Thus, with the aging of the population, the mechanism-based therapeutics for AD is desperately needed. This article will discuss the recent advances of the development of drugs based on "amyloid hypothesis", and the results of clinical trials. The inhibitors or modulators targeting beta- and gamma-secretases that are responsible enzymes for the generation of amyloid-beta peptide(Abeta) deposited in the Abeta brain, or Abeta immunotherapy using anti-Abeta antibodies, are promising candidates. Finally potential mechanism-based adverse effects of these treatments and the strategies to tackle these problems will be discussed.     

Molecular targeted therapy for renal cell carcinoma and other urological cancers

In Japan, therapeutic strategy for metastatic renal cell carcinoma(RCC) has been markedly changed since the recent introduction of multiple tyrosine kinase inhibitors, including sorafenib and sunitinib, into the clinical practice. In addition to these agents, inhibitors of mTOR(mammalian target of rapamycin) are scheduled to be available in patients with metastatic RCC near future. In this review, we would like to summarize the current status of these molecular targeted agents for the treatment of RCC, and subsequently describe the important issues associated with the administration of these agents, such as the effects on quality of life and the possible use as neoadjuvant setting. Finally, the prospects for the use of molecular targeted agents against urological cancers other than RCC are mentioned.