非小细胞肺癌靶向治疗固定剂量持续给药模式的利与弊  

Advantages and disadvantages of fixed and continuous dose regimen for targeted therapy of non-small cell lung cancer

作　　者：马进安[1] 吴元强[1] 马弋然 颜苗[3] MA Jin-an;WU Yuan-qiang;MA Yi-ran;YAN Miao(Department of Oncology,The Second Xiangya Hospital,Central South University,Changsha 410011;Department of Clinical Medicine,Hengyang Medical College,South China University,Hengyang Hunan 421200;Department of Pharmacology,The Second Xiangya Hospital,Central South University,Changsha 410011)

机构地区：[1]中南大学湘雅二医院肿瘤科,长沙410011 [2]南华大学衡阳医学院临床学系,湖南衡阳421200 [3]中南大学湘雅二医院药学部,长沙410011

出　　处：《中南药学》2023年第10期2755-2761,共7页Central South Pharmacy

基　　金：湖南省生物质基材料绿色低碳智造工程技术研究中心(No.2022TP2033)。

摘　　要：靶向治疗药物问世20余年,显著改善了肿瘤患者的生存,其固定剂量持续给药模式也暴露出不少弊端。考虑到东西方人群在遗传学、体重等方面存在差异,我们以非小细胞肺癌的研究数据为基础,剖析了EGFR-TKIs、ALK-TKIs存在的疑点问题,主要为固定剂量持续给药带来的疗效受损、远期安全性和药物经济性,提出了突破非小细胞肺癌靶向药物疗效瓶颈的五种策略,包括按体表面积/体重给药、合理联合传统治疗、下调靶向药物初始治疗剂量、创新动态给药模式、引入继发性耐药的预防概念,为优化靶向治疗提供参考。In recent twenty years,targeted drug therapy has been popular owing to the improvement in the survival of cancer patients.However,the fixed and continuous dosing regimen shows both disadvantages and advantages.There are obvious genetic and body-weight differences between eastern and western population groups,thus,we assume that patients from different population groups should be given different doses.By analyzing the data from non-small cell lung cancer(NSCLC),we found some problems in the fixed and continuous dosing schema of EGFR-TKIs and ALK-TKIs,including discounted effect,long-term safety and economic burden.Therefore,we proposed five strategies for the limitation of targeted therapy for NSCLC:dosing based on patients’body surface or weight,combining with traditional therapies,down-regulating the initial dose of targeted medicine,administrating the drug dose dynamically instead of a fixed dose,and preventing secondary drug resistance.These strategies help optimize the dose regimen of targeted medicine.

关 键 词：非小细胞肺癌 靶向治疗 给药模式 表皮生长因子受体酪氨酸激酶抑制剂 间变性淋巴瘤激酶酪氨酸激酶抑制剂 

分 类 号：R734.2[医药卫生—肿瘤]