人表皮生长因子受体2阳性非小细胞肺癌靶向治疗药物临床研究进展

肺癌已成为全球癌症患者死亡的主要原因,非小细胞肺癌占肺癌的85%,人表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)阳性非小细胞肺癌恶性程度较高,具有较高的复发和死亡风险。针对HER2阳性非小细胞肺癌的靶向治疗已成为研究热点,现有的靶向药物主要包括酪氨酸激酶抑制剂、单克隆抗体、抗体-药物偶联物、双特异性抗体和抗体-放射性核素偶联物。然而,目前尚无临床指南建议的标准治疗方案。本文就HER2阳性非小细胞肺癌靶向治疗药物的最新临床研究结果进行综述。     

基于定点偶联技术的抗体药物偶联物的临床研究进展与挑战

抗体药物偶联物是一类能够有效提高治疗指数的新一代抗肿瘤药物.传统的抗体药物偶联物使用非定点偶联技术,得到偶联位置和数目高度不均一的异质体,产品结构不均一,给产品质量的批间一致性控制带来挑战.定点偶联技术可以将小分子药物定点、定量地连接到抗体上,具有更好的药代动力学特性.简要总结了抗体药物偶联物的关键组成部分,抗体药物偶...     

用于肿瘤靶向治疗的前体药物研究进展

常规化疗因特异性差、不良反应大,对肿瘤患者的治疗效果有限.前体药物是一类通过连接子将药物与靶向分子(如抗体、多肽、核酸适体、聚合物等)连接成的药物偶联物,可提高药物向肿瘤部位递送的效率,提高化疗药物的疗效和安全性.本文介绍了几种可用于肿瘤靶向治疗的前体药物,如抗体-药物偶联物、多肽-药物偶联物、核酸适体-药物偶联物和聚...     

小型化抗体偶联药物及类似物的研究进展

在癌症治疗中,实体瘤的治疗效果一直是医药界关注的热点。临床上用于治疗实体瘤的靶向药物——抗体和抗体偶联药物存在其相对分子质量较大,导致穿透性有限的问题,在实体瘤治疗中无法发挥预期疗效,且由于其在体内的循环时间长,易对肝和其他组织产生脱靶毒性,限制治疗窗。使用小型化的偶联物或类似药物,如抗体片段偶联药物、支架抗体偶联物或多肽偶联物,将有利于药物快速穿透肿瘤组织,使毒素在肿瘤组织内迅速聚集,且相比于传统抗体偶联药物,小型化偶联物通过肾脏代谢比率增加,从而降低药物因长时间体循环导致的不良反应。但是其过短的半衰期会造成进入肿瘤的实际药量减少,因此也衍生出不同半衰期延长方法,以调节药物半衰期,增加药物进入肿瘤组织的总量,提高治疗效果。通过对不同的小片段技术和代表性药物的临床前或临床进展情况进行介绍,以及对其发展方向进行讨论,以期为小型化抗体偶联药物及类似物的研发提供参考。     

海洋细胞毒药物与抗体偶联物的制备及生物活性评价

目的 以抗体N-糖链为偶联位点,制备曲妥珠单抗与海洋细胞毒药物单甲基澳瑞他汀E(MMAE)偶联物,并研究其对乳腺癌细胞BT474的杀伤作用。 方法 合成含叠氮和炔基修饰的唾液酸化寡糖,采用化学酶法制备含叠氮或炔基修饰的曲妥珠单抗,利用生物正交反应分别制备相应的抗体药物偶联物。利用SDS-PAGE 对转糖基及偶联过程进行监测,表面等离子共振技术(SPR)对叠氮或炔基修饰前后抗体与FcγRIIIa亲和力进行检测。利用CCK-8法评价两种抗体药物偶联物对乳腺癌细胞株BT474的杀伤作用。结果 成功制备了含叠氮或炔基修饰的曲妥珠单抗及N-糖链糖基位点抗体药物偶联物,修饰抗体与FcγRIIIa的亲和力较曲妥珠单抗增加,相比曲妥珠单抗,两种抗体MMAE偶联物对BT474有更明显的生长抑制作用。结论 基于抗体糖链末端唾液酸位点偶联的方法可有效应用于海洋细胞毒抗体偶联药物的开发。     

抗体-药物偶联药物的研究进展

抗体-药物偶联物（ADC）也称为免疫偶联物,属于靶向抗肿瘤药物,由药物、抗体以及偶联抗体和药物的连接物所组成。当抗体和肿瘤细胞表面的抗原特异性结合时,抗体-药物偶联物可将药物成功释放到肿瘤细胞特定部位。本文主要概述抗体-药物偶联物的作用机理、分类以及相关药物的临床进展并重点介绍最新上市的药物曲妥珠单抗-美登木素I（T-DM1,Kadcyla）。     

弥漫大B细胞淋巴瘤治疗的研究进展

弥漫大B细胞淋巴瘤（DLBCL）属于侵袭性B细胞淋巴瘤,目前利妥昔单抗联合环磷酰胺+蒽环类+长春碱类+糖皮质激素（R-CHOP方案）已成为治疗DLBCL的一线治疗方案,但部分患者存在复发或疾病进展情况,针对这类患者的治疗仍是目前临床研究关注的重点。目前针对复发/难治DLBCL患者的治疗主要有抗体药物偶联物、靶向药物、免疫检查点抑制剂、细胞免疫治疗及造血干细胞移植等,有望为患者的疾病预后带来显著改善。     

抗体药物偶联物的研究进展

传统的癌症化疗常伴随着系统毒性,靶向治疗已成为当今肿瘤研究领域的热点。抗体-药物偶联物(antibody drug conjugates,ADCs)利用单克隆抗体(m ABs)对肿瘤细胞表面过表达抗原的特异性,将"弹头"药物(细胞毒药物)选择性地输送到肿瘤细胞中以改善药物治疗窗。ADCs由"弹头"药物、抗体和药物的偶联链三个部分组成,其兼具了抗体的高特异性和细胞毒素的高活性。而随着抗体药物偶联物brentuximab vedotin(SGN-35,Adcetris)和trastuzumab emtansine(T-DM1,Kadcyla)的成功上市,ADCs引起了人们极大的关注。本文综述ADC的分子特征以及组分优化选择,并简单介绍ADC的发展历程。     

肿瘤靶向抗体偶联物的研究进展

肿瘤靶向制剂已成为当今肿瘤治疗研究的热点,针对特定的靶点(抗原)可以制备相应的单抗。特异性单抗和蛋白毒素、放射性同位素、化疗药物偶联制备成相应的靶向抗体药物,这种抗体偶联物能增强药物的有效性,减少对正常组织的毒害。本文就三类肿瘤靶向抗体偶联物的特点、作用机制、上市药物以及发展趋势进行综述。     

抗体偶联药物的研发进展和挑战

抗体偶联药物（ADC）由单克隆抗体与不同数目的小分子毒素通过连接子偶联组成,是近年来肿瘤学发展较快的药物类别之一。由于兼具单抗药物的高靶向性以及细胞毒素在肿瘤组织中高活性的双重优点,ADC药物可高效杀伤肿瘤细胞,较化疗药物不良反应更低,较传统抗体类肿瘤药物具有更好的疗效,是近年来肿瘤创新药研发的热点。随着新一代工程抗体展现出良好的治疗前景以及新药研发技术的不断突破,抗体偶联药物经历了三个发展阶段,技术日臻成熟,但ADC药物还存在诸多问题和挑战。本文主要从抗体偶联药物的研发历程、抗体、连接子、偶联技术及细胞毒素的类型等方面进行综述,为ADC创新药物研发提供参考。     

Polymer-drug conjugates: recent development in clinical oncology

Targeted drug delivery aims to increase the therapeutic index by making more drug molecules available at the diseased sites while reducing systemic drug exposure. In this update, we provide an overview of polymer-drug conjugates that have advanced into clinical trials. These systems use synthetic water-soluble polymers as the drug carriers. The preclinical pharmacology and recent data in clinical trials with poly(l-glutamic acid)-paclitaxel (PG-TXL) are discussed. This is followed by a summary of a variety of polymeric conjugates with chemotherapeutic agents. Results from early clinical trials of these polymer-drug conjugates have demonstrated several advantages over the corresponding parent drugs, including fewer side effects, enhanced therapeutic efficacy, ease of drug administration, and improved patient compliance. Collectively, these data warrant further clinical development of polymer-drug conjugates as a new class of anticancer agents.     

抗体药物偶联物及其在恶性血液系统肿瘤治疗中的应用

单克隆抗体靶向治疗是目前临床肿瘤治疗的热点。针对抗体分子大而组织穿透性差以及临床使用剂量大、生产成本高的问题,抗体的小型化和高效性设计已成为抗体药物研发的新趋势。近年来,单抗与细胞毒性药物的结合物被称为抗体药物偶联物(antibody-drug conjugates,ADCs),已加入到抗癌药物的行列中,成为新型的抗体药物而受到广泛关注。泛义的ADC通常由抗体、接头(linker)和效应分子等3部分组成。根据效应分子的不同,可将ADC分为化学免疫偶联物、免疫毒素、放射性免疫偶联物等3类。ADC被内化进入细胞后,通过细胞内的化学和酶解作用释放出细胞毒性物质,细胞毒性物质则通过抑制蛋白合成、解聚微管蛋白或断裂双链DNA等作用而对靶细胞产生杀伤作用。近年来,FDA已经批准2种ADC药物上市,有多种处于II～III期临床试验阶段,取得了显著的临床效果,吸引了越来越多的制药企业争相竞逐。本文介绍ADC的过去和现状,结合临床肿瘤应用中的实际问题,探讨其将来的发展趋势。     

Anticancer carrier-linked prodrugs in clinical trials

Coupling of low molecular weight anticancer drugs to antibodies, serum proteins or polymers through a cleavable linker has been an effective method for improving the therapeutic index of cytotoxic established agents. Modern drug-antibody conjugates that have recently entered clinical trials have primarily used highly potent drugs such as calicheamicin or maytansins. Gemtuzumab ozogamicin, a conjugate of calicheamicin and an anti-CD33 humanized antibody, is the first drug-antibody conjugate to receive market approval. Drug conjugates that have undergone clinical assessment include N-(2-hydroxypropyl)methacrylamide (HPMA) copolymer conjugates with doxorubicin, camptothecin, paclitaxel and Pt(II) complexes, poly(ethylene glycol) conjugates with camptothecin and paclitaxel, polyglutamate conjugates with paclitaxel and camptothecin, a methotrexate-albumin conjugate and an albumin-binding doxorubicin prodrug. This review summarizes the Phase I-III studies that have been performed with these macromolecular prodrugs.     

Antibody-Targeted Drugs for the Therapy of Cancer

Abstract

The advent of monoclonal antibodies has revitalised the concept of magic bullets and various agents (eg. drugs, toxins and isotopes) have been conjugated to monoclonal antibodies for selective delivery to tumours. Preclinical studies in mouse tumour models have been impressive and have lead to several clinical trials. These phase I trials have been less impressive. However, keeping in mind the aim of Phase I trials, the safety of using these conjugates in humans have been established. Several, major problems still remain to be overcome before these agents may be useful for the treatment of cancer. These problems stem from the nature of tumour vasculature, cytotoxic activity of the moiety linked to antibody and the targeted tumour antigen expressed on the cell surface. This review will deal with these various aspects described above and possible approaches to overcome these obstacles with a definite bias towards drug-monoclonal antibody conjugates. However, these concepts are equally applicable for improved targeting of other agents.     

Therapeutic applications of lipoic acid: a patent review (2011 – 2014)

Introduction: Lipoic acid (LA), a naturally occurring 1,2-dithiolane analog that plays an essential role in mitochondrial bioenergetic reactions, has gained unprecedented attention as nutritional supplement and as therapeutic agent. Moreover, LA conjugates with other pharmacophores represent a promising approach toward the development of multifunctional drugs.

Areas covered: The reviewed patent applications from January 2011 to April 2014 include combinations of LA with other bioactive compounds as well as LA conjugates for the treatment of a wide range of clinical conditions. Additionally, some patents disclose methods to overcome the stability problems of LA.

Expert opinion: LA is currently in clinical use for the treatment of diabetic neuropathy, while small clinical trials using combinations of LA with known bioactive agents have been undertaken. The use of the LA is hampered by its instability and its rapid metabolism. Thus, formulations containing LA, in a form ensuring its stability and improving its bioavailability, can have important applications as medicines, nutritional supplements or cosmeceuticals. LA hybrids with other pharmacophores endowed with various activities, possess an enormous potential to promote human health and have been the subject of numerous publications and patent applications. Nevertheless, reliable in vivo data and clinical trials are necessary to prove these beneficial effects.     

Do HPMA copolymer conjugates have a future as clinically useful nanomedicines? A critical overview of current status and future opportunities

N-(2-Hydroxypropyl)methacrylamide (HPMA) copolymer conjugates containing doxorubicin designed in the late 1970s/early 1980s as anticancer polymer therapeutics were the first synthetic polymer-based anticancer conjugates to enter clinical trial beginning in 1994. Early clinical results were promising, confirming activity in chemotherapy refractory patients and the safety of HPMA copolymers as a new polymer platform in this setting. Subsequent Phase I/II trials have investigated conjugates containing paclitaxel (PNU 166945), camptothecin (PNU 166148) (both failed in clinical trials underlining the importance of rational design), and most recently HPMA-copolymer platinates (AP5280 and then AP5346-ProLindac^TM) entered Phase II clinical development. There are a growing array of second generation HPMA copolymer-based systems involving combination therapy, incorporating putative targeting ligands, having an ever more complex architecture, and both drug and protein conjugates are being proposed as novel treatments for diseases other than cancer. Despite their promise, and the success of polymeric drugs and polymer-protein conjugates, no polymer-drug conjugate (HPMA copolymer-based or otherwise) has yet entered routine clinical use. It is timely to reflect on the progress made over the last 30 years, the relative merits of HPMA copolymers as a platform compared to other polymeric carriers, and comment on their future potential as polymer-based nanomedicines into the 21st century in comparison with the many alternative strategies now emerging for creation of nanopharmaceuticals.     

Anticancer carrier-linked prodrugs in clinical trials

Coupling of low molecular weight anticancer drugs to antibodies, serum proteins or polymers through a cleavable linker has been an effective method for improving the therapeutic index of cytotoxic established agents. Modern drug–antibody conjugates that have recently entered clinical trials have primarily used highly potent drugs such as calicheamicin or maytansins. Gemtuzumab ozogamicin, a conjugate of calicheamicin and an anti-CD33 humanized antibody, is the first drug–antibody conjugate to receive market approval. Drug conjugates that have undergone clinical assessment include N-(2-hydroxypropyl)methacrylamide (HPMA) copolymer conjugates with doxorubicin, camptothecin, paclitaxel and Pt(II) complexes, poly(ethylene glycol) conjugates with camptothecin and paclitaxel, polyglutamate conjugates with paclitaxel and camptothecin, a methotrexate–albumin conjugate and an albumin-binding doxorubicin prodrug. This review summarizes the Phase I – III studies that have been performed with these macromolecular prodrugs.     

PEG conjugates in clinical development or use as anticancer agents: An overview

During the almost forty years of PEGylation, several antitumour agents, either proteins, peptides or low molecular weight drugs, have been considered for polymer conjugation but only few entered clinical phase studies. The results from the first clinical trials have shared and improved the knowledge on biodistribution, clearance, mechanism of action and stability of a polymer conjugate in vivo. This has helped to design conjugates with improved features. So far, most of the PEG conjugates comprise of a protein, which in the native form has serious shortcomings that limit the full exploitation of its therapeutic action. The main issues can be short in vivo half-life, instability towards degrading enzymes or immunogenicity. PEGylation proved to be effective in shielding sensitive sites at the protein surface, such as antigenic epitopes and enzymatic degradable sequences, as well as in prolonging the drug half-life by decreasing the kidney clearance. In this review PEG conjugates of proteins or low molecular weight drugs, in clinical development or use as anticancer agents, will be taken into consideration. In the case of PEG-protein derivatives the most represented are depleting enzymes, which act by degrading amino acids essential for cancer cells. Interestingly, PEGylated conjugates have been also considered as adjuvant therapy in many standard anticancer protocols, in this regard the case of PEG-G-CSF and PEG-interferons will be presented.     

喹诺酮类抗菌药物研究新进展

本文简述了喹诺酮类药物近几年的研究进展,分为上市药物、临床试验药物和未来发展趋势三部分,对目前处于临床研究阶段的药物做了重点讲述,其中delafloxacin是最有希望的喹诺酮类候选药物,同时介绍了喹诺酮类抗菌药物的未来发展方向,即侧链修饰、喹诺酮类似物、喹诺酮杂合物和TB药物与喹诺酮扼合物.     

The dawning era of polymer therapeutics

As we enter the twenty-first century, research at the interface of polymer chemistry and the biomedical sciences has given rise to the first nano-sized (5-100 nm) polymer-based pharmaceuticals, the 'polymer therapeutics'. Polymer therapeutics include rationally designed macromolecular drugs, polymer-drug and polymer-protein conjugates, polymeric micelles containing covalently bound drug, and polyplexes for DNA delivery. The successful clinical application of polymer-protein conjugates, and promising clinical results arising from trials with polymer-anticancer-drug conjugates, bode well for the future design and development of the ever more sophisticated bio-nanotechnologies that are needed to realize the full potential of the post-genomic age.