摘要
结直肠癌是死亡率的最高的癌症之一。虽然早期结直肠癌患者(I期和II期)的5年生存率在60%以上,但超过50%的患者在远处转移时已经确诊或超过III期,5年生存率下降到10%。化疗介入加手术是转移性结直肠癌治疗的关键,也是提高生存率的唯一手段。几十年后发现,抗代谢药物5氟尿嘧啶(5-FU)是唯一可用的化疗药物,这种化疗药物成功地延长结直肠癌患者存活时间12个月。多年来,转移性结直肠癌的治疗被认为是治标不治本的,一般的治疗旨在增加患者剩余生命的持续时间和质量,几乎没有治愈的希望,因此新的DNA和RNA靶向治疗在治疗结直肠癌中有着重要的意义。在过去的几十年中,多种化疗药物的组合已被纳入常规临床实践中。结合伊立替康的联合用药制度,一种半合成的拓扑异构酶,奥沙利铂,第三代铂类化合物抑制剂,通过DNA加合物的形成而导致有丝分裂受阻,如5-氟尿嘧啶的前体药物卡培他滨,现在已经确定了其作为一线、二线和序贯治疗结肠癌的方案。这篇综述简要介绍了结肠癌化疗的进展以及正在发现的治疗方案。
关键词: 结肠直肠癌,化疗,5-氟尿嘧啶,卡培他滨和亚叶酸,顺-二氯二氨络铂和奥沙利铂,联合化疗,靶向治疗和消炎药,钌,PARP抑制剂
Current Medicinal Chemistry
Title:Colorectal Cancer Chemotherapy: The Evolution of Treatment and New Approaches
Volume: 24 Issue: 15
关键词: 结肠直肠癌,化疗,5-氟尿嘧啶,卡培他滨和亚叶酸,顺-二氯二氨络铂和奥沙利铂,联合化疗,靶向治疗和消炎药,钌,PARP抑制剂
摘要: Colorectal cancer (CRC) is one the greatest contributors to cancer related mortality. Although 5 year survival rate for patients at the early stage of CRC (stages I and II) is above 60%, more than 50% of patients are diagnosed at or beyond stage III when distant metastasis has already occurred, in which case 5 year survival rate drops to 10%. Chemotherapeutic intervention coupled with surgery is the backbone of metastatic CRC treatment and the only means of enhanced survival. For decades following its discovery, an antimetabolite 5- fluorouracil (5-FU) was the only chemotherapeutic agent available to successfully improve 12 month survival in CRC patients. Treatment of metastatic CRC has been considered palliative for many years; aiming to increase the duration and quality of the patient's remaining life, with little hope of cure, highlighting the need for novel DNA and RNA targeted therapies in the treatment of CRC. Over the last several decades, combinations of several chemotherapeutic agents have been incorporated into routine clinical practice. Combination regimes incorporating irinotecan, a semisynthetic inhibitor of topoisomerase, oxaliplatin, a third-generation platinum compound that causes mitotic arrest via the formation of DNA adducts, and capecitabine, a 5-FU prodrug, are now all established options for use as first-line, second-line and sequential treatment of CRC. This review provides a brief overview of the evolution of CRC chemotherapy as well as new and emerging treatment options.
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Colorectal Cancer Chemotherapy: The Evolution of Treatment and New Approaches, Current Medicinal Chemistry 2017; 24 (15) . https://dx.doi.org/10.2174/0929867324666170111152436
DOI https://dx.doi.org/10.2174/0929867324666170111152436 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
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