杨清杰|孙晓雁|综述|郭明|审校. 舒尼替尼治疗非小细胞肺癌的现状[J]. 中国肿瘤临床, 2011, 38(15): 923-926. DOI: 10.3969/j.issn.1000-8179.2011.15.015
引用本文: 杨清杰|孙晓雁|综述|郭明|审校. 舒尼替尼治疗非小细胞肺癌的现状[J]. 中国肿瘤临床, 2011, 38(15): 923-926. DOI: 10.3969/j.issn.1000-8179.2011.15.015
Qingjie YANG. Sunitinib for Treating Non-Small Cell Lung Cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2011, 38(15): 923-926. DOI: 10.3969/j.issn.1000-8179.2011.15.015
Citation: Qingjie YANG. Sunitinib for Treating Non-Small Cell Lung Cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2011, 38(15): 923-926. DOI: 10.3969/j.issn.1000-8179.2011.15.015

舒尼替尼治疗非小细胞肺癌的现状

Sunitinib for Treating Non-Small Cell Lung Cancer

  • 摘要: 苹果酸舒尼替尼(sunitinib malate)是目前临床上使用的多靶点酪氨酸激酶抑制剂之一。可抑制包括表皮生长因子受体、血小板源性生长因子受体、血管内皮生长因子受体在内的80多种受体的酪氨酸激酶。而受体酪氨酸激酶(RTK)的突变和过度表达被证实与包括肺癌在内的多种肿瘤的发生及发展有关。因此部分学者进行了用舒尼替尼单药或联合化疗药物(如紫杉醇、吉西他滨+顺铂)治疗进展期非小细胞肺癌的临床试验,试验结果显示舒尼替尼对非小细胞肺癌有一定的疗效。其中舒尼替尼联合吉西他滨+顺铂的临床试验显示最大耐受剂量方案:舒尼替尼(37.5 mg口服 1次/日,2/1方案)+吉西他滨(1 000 mg/m2,静脉用药,d1、8,3周方案,)+顺铂(80 mg/m2,静脉用药,d1,3周方案)的部分缓解率高达66.7%。而且在临床试验中出现的舒尼替尼的毒副作用大多为1~2级,大部分患者能较好耐受。这提示舒尼替尼在非小细胞肺癌的治疗上可能有一定的运用前景,但目前相关的研究仍较少,如对舒尼替尼在不同组织学类型及基因突变情况的非小细胞肺癌中疗效差异等的研究均未见报道。

     

    Abstract: Abstract Sunitinib malate is one of the multi-targeted tyrosine kinase inhibitors in clinical use. It inhibits the tyrosine kinase of over 80 receptors, including the receptors of epidermal growth factor, platelet-derived growth factor, and vascular endothelial growth factor. Since 2006, it has been successfully administered to treat advanced renal cell carcinoma and imatinib-resistant or intolerant gastrointestinal stromal tumors. In addition, the mutation and overexpression of tyrosine kinase receptors are related to the oncogenesis and progression of several tumors, including lung cancer. Therefore, authors have used sunitinib to treat non-small cell lung cancer (NSCLC) using sunitinib-only regimens, continuous daily doses, or combination chemotherapy (with docetaxel or gemcitabine plus cisplatin), with a definite curative effect in NSCLC clinical trials. Trials involving combined therapy using sunitinib with gemcitabine and cisplatin for advanced NSCLC have shown that the maximum tolerated dose is as follows: intermittent oral sunitinib 37.5 mg/d once a day, (Schedule 2/1, i.e., 1 week withdrawal after a 2-week administration) with intravenous infusions of gemcitabine (1,000 mg/m2 on days 1 and 8) and cisplatin (80 mg/m2 on day 1), administered in 3-week cycles. Up to 66.7% of the patients were confirmed to achieve partial response. The adverse side effects of sunitinib that occurred during the clinical trials were generally tolerated in most of the patients, including fatigue/asthenia, pain/myalgia, nausea/vomiting, stomatitis/mucosal inflammation, and hypertension, which were mild to moderate in severity (grades 1 to 2). This suggests that sunitinib may play a more important role in the treatment of NSCLC. However, few results are currently available from related studies. Therefore, more findings from studies on sunitinib are expected, such as the various curative effects of sunitinib in different histology types and genetic mutations of NSCLC.

     

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