Therapeutic approaches to bladder cancer: identifying targets and mechanisms
Therapeutic approaches to bladder cancer: identifying targets and mechanisms
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DOI：
10.1016/s1040-8428(03)00066-0
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发表时间：
2003-06-27
影响因子：
6.2
通讯作者：
Datar, RH
中科院分区：
文献类型：
--
作者：
Cote, RJ;Datar, RH
移行细胞癌是美国第二常见的泌尿生殖系统恶性肿瘤，也是泌尿生殖系统肿瘤中第三常见的死亡原因。膀胱癌的治疗选择包括手术，通常结合化疗、放疗和/或免疫治疗。MVAC辅助化疗方案已广泛应用于局部侵袭性和转移性疾病。只有一部分有风险的患者会对治疗有反应。因此，需要确定对辅助治疗有良好反应的患者，并确定新的靶点来治疗更大范围的患者。基于通路或已知标记物的患者特异性畸变，现有的和新的治疗方法都可以根据患者肿瘤的进展风险和分子改变来定制，以使患者受益。因此，靶向治疗被定义为针对机制和风险的治疗。利用现有的膀胱癌细胞周期调控、信号转导、细胞凋亡和血管生成的分子生物学知识，我们回顾了膀胱癌的潜在治疗靶点，以进行合理的药物开发。最后，使用膀胱癌作为转化研究的模型，提出了所需的临床试验要求。(C) 2003爱思唯尔科学爱尔兰有限公司版权所有。
Transitional cell carcinoma is the second most common genitourinary malignancy in US and third most common cause of death among genitourinary tumors. Treatment options for bladder cancer include surgery, often combined with chemotherapy, radiation, and/or immunotherapy. The MVAC adjuvant chemotherapy regimen has been most widely used in locally invasive as well as metastatic disease. Only a proportion of patients at risk will respond to therapy. There is thus need to identify good responder patients for adjuvant therapy and to identify new targets to treat a greater range of patients. Based upon patient-specific aberrations in pathways or known markers, both existing and new therapies can be tailored to benefit patients based on the risk of progression and molecular alterations specific to a patient's tumor. Targeted therapy, therefore, is defined as therapy that targets mechanism and risk. Utilizing the available knowledge of the molecular biology of cell-cycle regulation, signal transduction, apoptosis, and angiogenesis in bladder cancer, we review the potential therapeutic targets for rational drug development. Finally, using bladder cancer as a model for translational research, requirements for a desired clinical trial are presented. (C) 2003 Elsevier Science Ireland Ltd. All rights reserved.