摘要
在人类癌症中,对TP53功能的抑制几乎是普遍存在的,而且相当一部分癌症存在TP53基因本身的突变。因此,野生型TP53基因已成为癌症基因治疗转化研究的重要靶基因。2003年,首个抗肿瘤基因治疗药物rAd-p53(重组人p53腺病毒),商品名为Gendicine™,获国家食品药品监督管理局批准,用于治疗头颈部鳞癌(HNSCC)联合放疗。通过构建腺病毒载体将重组人TP53基因导入癌细胞,表达p53功能蛋白。虽然目前批准的唯一使用Gendicine(重组人p53腺病毒注射液)联合放疗治疗HNSCC,但已经开展了20余项Gendicine治疗癌症的临床研究,包括晚期肺癌、晚期肝癌、妇科恶性肿瘤和软组织肉瘤的治疗。目前已有3万多名患者接受了该药物的治疗。本文综述了金二嗪在中国的临床应用概况。我们总结了48项研究,涉及2561例实体肿瘤患者,其中包括34项对照临床研究和14项开放临床研究,即没有对照组的临床研究。头颈部癌11例,肝癌10例,妇科恶性肿瘤6例,非小细胞肺癌4例,软组织肉瘤4例,恶性积液4例,胃肠道肿瘤2例,其他肿瘤7例。在所有报告的临床研究中,最常见的副作用是自限性发热。瘤内注射和动脉内注射是最常见的给药途径。总体而言,Gendicine(重组人p53腺病毒注射液)联合化疗、放疗或其他常规治疗方案与单独使用标准治疗相比,显示出明显更高的有效率。一些已发表的研究还表明,与单独的传统治疗相比,Gendicine(重组人p53腺病毒注射液)联合治疗显示了更长的无进展生存时间。到目前为止,Gendicine(重组人p53腺病毒注射液)在中国临床用于治疗非HNSCC以外的癌症已有十多年,主要用于晚期或不可切除的恶性肿瘤患者。然而,TP53基因治疗仍需建立规范的治疗方案,以促进其在临床的应用。
关键词: TP53
图形摘要
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