治疗结肠直肠癌的靶向药物帕尼单抗临床评价

帕尼单抗是靶向表皮生长因子受体(EGFR)的第一个完全人源化单克隆抗体,主要用于实体瘤治疗,其可直接拮抗受体细胞外配体结合区,阻断下游信号通道.体内外试验及Ⅰ～Ⅲ期临床研究证明,其一般耐受良好,几无输液反应,是治疗转移性结肠直肠癌(mCRC)很有希望的药物.帕尼单抗是继贝伐单抗和西妥昔单抗之后获美国FDA批准治疗耐药mCRC的靶向药物,其单用或与标准化疗药物联合应用均有效,为mCRC患者提供了更多的治疗选择并可改善患者预后.     

食管癌化疗的演变及其在综合治疗中的作用

本文评述食管癌化疗的前景与困难.全身化学治疗有可能提高食管癌患者缓解率,延长生存期和改善生活质量.联合化疗治疗食管癌有明显优越性.顺铂 氟尿嘧啶(加或不加醛氢叶酸)认为是最佳联合化疗药物,对食管鳞癌的有效率为42%～66%,对食管腺癌的有效率为27%～48%.评价较新的化疗药物,包括紫杉醇类和喜树碱类(如伊利替康)可有助于选择更为有效和较好耐受的全身治疗方案.由于单用手术或单用放疗的患者预后较差,推动食管癌的综合治疗.目前临床试验有术前(新辅助)化疗,术前同时联合化-放疗,或对局部区域病变单用化-放疗,以及对有高复发危险的患者行术后(辅助)化疗,将有助于为食管癌患者提供最佳的治疗方案.     

CHEMOPREVENTION OF LUNG CANCER IN THE HIGH INCIDENCE AREA

Since 1984, mass screening for cancer and chemopreventive trials in the two high incidence areas of lung cancer have been carried out. Chemo preventive trials on the subjects having moderate or severe atypical hyperplasia cells in the sputum were done by treatment with R1 [N-(p-ethoxycarbophenyl) retinamide] and R2 [N-(p-carboxyphenyl) retina-mide]. Results showed that the general status of the patients had improved. IgA and IgM in the serum were increased and the arsenic skin lesions were relieved after the treatment with Rl and R2. The ratio of the incidence of lung cancer for the treated group and the control group was 1:4, and the mean degree of hyperplasia in the sputum had dropped. It is suggested that these drugs are both safe and effective in the chemoprevention of lung cancer.     

化疗的进展与治疗策略的转变

内科肿瘤学的诞生与发展,与新抗癌药的不断发现及其深入研究密切相关。随着分子生物学,基因工程技术的进步,抗癌药研究与开发进入了一个新阶段,同时,在临床治疗策略上也产生了相应的改变。本文概述抗肿瘤药物的部分新进展与治疗策略上的某变化。１　抗肿瘤药的新靶点与新抗癌药１．１　新靶点　抗癌药物研究目前已超出传统的核酸及其组成成为靶点的细胞毒型药物,出现了新作用靶点。如①新的抗微管药：紫衫醇（ｔａｘｏｌ）是目前惟一促进微管聚合,且能抑制微管解聚的药物。②ＤＮＡ拓扑异构酶抑制剂：以ＴｏｐｏＩ为靶点的药物有喜树…