腫瘍学における抗血管新生療法:現状と将来の方向性
Gordon C Jayson1, Robert Kerbel2, Lee M Ellis3
1Institute of Cancer Sciences and Christie Hospital, University of Manchester, Manchester, UK.
Lancet (London, England)
|February 9, 2016
まとめ
血管内皮成長因子 (VEGF) 経路阻害剤は,一部の癌において適度な有効性を示しています. 予測可能なバイオマーカーの開発は これらの血管新生抑制療法から恩恵を受ける患者を特定するために重要です
科学分野:
- 腫瘍学
- 分子生物学
- 薬物開発
背景:
- 血管新生 つまり新しい血管の形成は 複数の癌の治療対象として実証されています
- 血管内皮成長因子 (VEGF) 経路阻害剤は確立された治療法ですが,有効性は腫瘍の種類によって大きく異なります.
- 現行の治療法では 進行性および全生存率のわずかな改善が見られ,さらなる研究が必要である.
研究 の 目的:
- 血管新生抑制療法における予測バイオマーカーの必要性を強調する.
- 患者の階層化のためのバイオマーカー開発の課題と重要性を議論する.
- 併用療法による新しい治療戦略を探求する
主な方法:
- VEGF経路阻害剤を調査したランダム化試験のレビュー
- 血管新生抑制薬に対する腫瘍の分化反応の分析
- 新興の組み合わせ療法と薬物メカニズムの探索
主要な成果:
- VEGF阻害剤は腎臓細胞癌,卵巣癌,子宮頸癌,および臓神経内分泌腫瘍に有効である.
- 前立腺がん,臓腺がん,およびメラノーマは,これらの薬剤に耐性を示す.
- 患者の選択の必要性を強調した.
結論:
- 予測性バイオマーカーは,有効性,毒性,費用のバランスをとって,抗血管新生療法を最適化するために不可欠です.
- 薬の免疫調節やその他のメカニズムを理解することで 新しい組み合わせの戦略が生まれます
- がん治療の成果を向上させるためには,予測可能なバイオマーカーと組み合わせた治療法に関するさらなる研究が必要である.
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