Current Status of Clinical Trials for Small Cell Lung Cancer
Current Status of Clinical Trials for Small Cell Lung Cancer
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DOI：
10.2174/157488708783330503
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发表时间：
2008-01-01
影响因子：
1.9
通讯作者：
Arcaro, Alexandre
中科院分区：
文献类型：
--
作者：
Fischer, Barbara;Arcaro, Alexandre
SCLC占所有肺癌病例的13%，是最具侵袭性的肺癌形式，总体5年生存率低于5%。顺铂或卡铂与依托泊苷的组合仍然是SCLC的标准治疗。尽管对治疗有良好的初始反应，但大多数SCLC患者遭受化疗耐药性和复发的发展。为了改善SCLC的结果，最近已经将新的药物如拓扑替康、伊立替康、氨柔比星、紫杉醇或吉西他滨加入到化疗方案中。与依托泊苷或铂类药物联合使用，其中一些药物可能能够提供显着的生存益处。此外，最近对小细胞肺癌生物学的理解取得了进展，导致了对关键信号通路的识别，这使得针对该疾病的特异性靶向治疗得以发展。许多新分子目前正在SCLC中进行临床评价。这些抑制剂靶向蛋白酶体、受体酪氨酸激酶、法尼基转移酶、Bcl-2或血管生成途径。一些研究表明，这些新的策略可以与化疗相关，并显示出积极的结果。本文综述了最近的临床试验进行新的化疗方案和目前的状态，具体的靶向方法在小细胞肺癌患者。
SCLC represents 13% of all lung cancer cases and is the most aggressive form of lung cancer with an overall 5year survival less than 5%. The combination of cisplatin or carboplatin with etoposide remains the standard treatment for SCLC. Despite a good initial response to therapy, most SCLC patients suffer from the development of chemotherapy resistance and relapse. Second-line chemotherapy should then be applied, which however frequently results in only a low survival increase.To improve the outcome of SCLC, new drugs such as topotecan, irinotecan, amrubicin, paclitaxel or gemcitabin have recently been added to chemotherapeutic regimens. In combination with etoposide or platinum-based agents, some of these drugs could be able to offer a significant survival benefit.Moreover, recent progress in the understanding of SCLC biology has led to the identification of critical signaling pathways, which allowed the development of specific targeted therapies for the disease. A number of new molecules are currently under clinical evaluation in SCLC. These inhibitors target the proteasome, receptors tyrosine kinases, farnesyltransferase, Bcl-2, or angiogenic pathways. Some studies have demonstrated that these new strategies can be associated with chemotherapy and show positive results. This review summarizes recent clinical trials performed with new chemotherapeutic regimens and the current status of specific targeted approaches in SCLC patients.