耐火性转移性结直肠癌中的多酶抑制剂:一个最佳的序列?
Celine Hoyek1, Angelo Pirozzi1,2,3, Naohiro Okano1,4
1Department of Hematology and Oncology, Mayo Clinic Arizona, Phoenix.
Clinical advances in hematology & oncology : H&O
|February 20, 2026
概括
对于耐火性转移性结直肠癌,治疗顺序是关键. 现实世界的数据表明,特定的药物订单可能会改善结果,但对个性化护理需要更多的研究.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 临床药理学 临床药理学
背景情况:
- 转移性结直肠癌 (mCRC) 是一个重大的临床挑战,大多数患者在初始治疗后进展.
- 耐火性mCRC,定义为经过两种或多种疗法后的进展,具有不断增长但未定义的治疗序列格局.
- 已获批准的治疗方法,如雷戈拉费尼布,trifluridine/tipiracil (FTD/TPI) 和fruquintinib提供了适度的生存益处.
研究的目的:
- 审查目前关于耐火转移性结直肠癌测序策略的证据.
- 确定关于耐火mCRC的最佳治疗顺序的知识差距.
- 突出未来研究的必要性,以指导个性化治疗选择.
主要方法:
- 对已批准的耐火mCRC疗法的第三阶段试验数据的审查.
- 对药物测序结果的真实世界数据的分析.
- 评估影响耐火mCRC临床决策的因素.
主要成果:
- 目前还没有直接的比较研究来确定regorafenib,FTD/TPI和fruquintinib的最佳测序.
- 现实世界的数据表明,在FTD/TPI之前对regorafenib进行测序可能会改善结果.
- 在FTD/TPI中添加贝瓦齐祖马布和在其他药物后使用果丁尼布显示出有效性.
结论:
- 目前,耐火性mCRC的治疗决定是个性化的,考虑患者因素和药物耐受性.
- 生物标志物测试对于个性化治疗选择在耐火mCRC中至关重要.
- 进一步的研究对于建立基于证据的测序策略,以有效和可持续的耐火mCRC治疗至关重要.
相关概念视频
Combination Therapies and Personalized Medicine
6.2K
Combining two or more treatment methods increases the life span of cancer patients while reducing damage to vital organs or tissue from the overuse of a single treatment. Combination therapy also targets different cancer-inducing pathways, thus reducing the chances of developing resistance to treatment.
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
6.2K
Targeted Cancer Therapies
9.0K
The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against...
There are several types of targeted therapies against...
9.0K
Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
668
Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy. SP binds and activates...
668
Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
726
5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
726
Treatment Resistant Cancers
3.8K
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
3.8K
Inhibition of Cdk Activity
6.1K
The orderly progression of the cell cycle depends on the activation of Cdk protein by binding to its cyclin partner. However, the cell cycle must be restricted when undergoing abnormal changes. Most cancers correlate to the deregulated cell cycle, and since Cdks are a central component of the cell cycle, Cdk inhibitors are extensively studied to develop anticancer agents. For instance, cyclin D associates with several Cdks, such as Cdk 4/6, to form an active complex. The cyclin D-Cdk4/6 complex...
6.1K


