組み合わせたがん治療の設計について
James H Doroshow1, Richard M Simon2
1Division of Cancer Treatment and Diagnosis, National Cancer Institute, NIH, Bethesda, MD, USA; Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD, USA.
Cell
|December 16, 2017
まとめ
併用がん治療は臨床的な相乗効果が限られている. 研究によると 成功する治療法でさえ 組み合わせた相互作用ではなく 個々の薬剤効果によって 効果を発揮することが多く 現在のがん薬の開発方法に 異議を唱えています
科学分野:
- 腫瘍学
- 薬理学について
- 翻訳医学
背景:
- 組み合わせ治療はヒトの悪性腫瘍の標準治療である.
- 治療の有効性を高めるために,相乗効果のある薬物相互作用が求められます.
研究 の 目的:
- in vitroで観察された同效抗がん薬の相互作用の臨床翻訳を評価する.
- 併用治療の成功は,薬剤の作用の相乗効果によるのか,それとも独立した作用によるのかを判断する.
主な方法:
- 細胞培養データによる薬剤相互作用の分析
- 組み合わせ治療のマウスモデルとヒト臨床試験の結果のレビュー
主要な成果:
- 臨床的有効性を示すのは稀である.
- 組み合わせた治療の成功は しばしば個々の薬の加減効果によって説明される.
- 臨床結果は,in vitroの相乗効果の発見を一貫して支持するものではありません.
結論:
- 抗がん薬の相乗効果の臨床的関連性は疑わしい.
- 薬剤による独立活動は 組み合わせ治療の成功の説明となる可能性が高い.
- 併用がん治療の臨床前モデルと臨床試験の分析を再考することが必要である.
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