转移性结直肠癌靶向药物的耐药机制及中医药治疗策略  

Resistance mechanism of targeted drugs in metastatic colorectal cancer and therapeutic strategies of traditional Chinese medicine

作　　者：姜沙沙 张影茹 王炎[1] JIANG Shasha;ZHANG Yingru;WANG Yan(Department of Oncology/Cancer Institute,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院肿瘤科/肿瘤研究所,上海201203

出　　处：《上海中医药大学学报》2024年第2期1-7,共7页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(82122075);上海市炎癌转化病症生物学前沿研究基地(2021KJ03-12);上海市教委“曙光计划”(21SG43);上海申康医院发展中心临床三年行动计划项目(SHDC2020CR4043)。

摘　　要：分子靶向治疗是转移性结直肠癌(mCRC)的主要治疗方法之一,联合化学疗法可使患者的总生存期(OS)、无进展生存期(PFS)显著获益。临床常用的分子靶向药物主要包括小分子信号传导抑制剂和大分子单克隆抗体。但靶向治疗后期产生的耐药问题成为临床上治疗的关键难题。研究表明,靶向药物耐药机制可能与多种因素相关,包括表皮生长因子受体(EGFR)、血管内皮生长因子(VEGF)、人表皮生长因子受体-2(HER2)等相关细胞信号通路异常以及肿瘤微环境改变等。近年来,研究发现中医药治疗在逆转靶向药物耐药方面颇有成效。因此,该文对CRC分子靶向治疗耐药机制以及中医药应对策略进行论述,并对逆转靶向耐药的中药及其有效成分进行探讨。Molecular targeted therapy is one of the main treatment options for metastatic colorectal cancer(mCRC),and combined with chemotherapy,it can provide significant benefits in patients'overall survival(OS)and progression-free survival(PFS).Commonly used molecular targeted drugs in clinic mainly includes small molecule signal transduction inhibitors and large molecule monoclonal antibodies.However,the problem of drug resistance in the later stage of targeted therapy becomes a key challenge for clinic treatment.Studies have shown that the mechanism of targeted drug resistance may be related to a variety of factors,including abnormalities in related cell signaling pathways such as epidermal growth factor receptor(EGFR),vascular endothelial growth factor(VEGF),human epidermal growth factor receptor 2(HER2)and alterations in tumor microenvironment.In recent years,studies have found that traditional Chinese medicine are quite effective in reversing targeted drug resistance.Therefore,this article discusses the mechanisms of drug resistance to molecular targeted therapy in CRC,as well as the coping strategies of traditional Chinese medicine,and discusses the tradional Chinese medicine and its active ingredients that can reverse targeted drug resistance.

关 键 词：靶向治疗 结直肠癌 耐药 中医药 

分 类 号：R273[医药卫生—中西医结合]