为什么癌症药物开发的临床前模型失败
David A Gewirtz1, Beverly Teicher2, Edward Greenberg3
1Virginia Commonwealth University Richmond, VA United States.
概括
大多数抗癌药物在临床试验中失败,因为细胞培养和动物研究等临床前模型无法准确预测人类的反应. 改进这些模型对于有效的癌症药物开发至关重要.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 翻译医学是一种翻译医学.
背景情况:
- 临床前抗癌药物开发通常依赖于细胞培养和动物模型.
- 这些模型往往无法预测临床疗效,导致药物开发中的高消耗率.
- 药理动力学的关键差异和模型中免疫系统参与的缺乏导致了这种翻译差距.
研究的目的:
- 突出目前在抗癌药物开发中的临床前模型的局限性.
- 确定阻碍临床前发现转化为临床成功的因素.
- 建议修改以提高临床前模型的实用性和增强临床翻译.
主要方法:
- 在抗癌药物开发中使用的常见临床前模型的审查和分析.
- 在临床前模型和人类患者之间检查药物动力学 (ADME) 和免疫学差异.
- 讨论现有文献和关于模型限制的专家意见.
主要成果:
- 临床前模型经常高估药物的疗效,原因是简化的生物系统和缺乏人类特异性因素.
- 物种之间的药理动力学 (药物吸收,分布,新陈代谢,分泌) 差异是显著的.
- 使用免疫缺陷模型排除了免疫系统在抗癌药物反应中的关键作用.
结论:
- 目前的临床前模型具有显著的局限性,阻碍了抗癌药物的成功转化到临床.
- 需要对临床前模型进行修改,包括与人类相关的药理动力学和免疫系统功能.
- 探索基于人体细胞和基于计算机的替代测试可能会提高临床结果的预测能力.
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