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Pazopanib in advanced soft tissue sarcomas.
Signal Transduction and Targeted Therapy ( IF 40.8 ) Pub Date : 2019-05-17 , DOI: 10.1038/s41392-019-0049-6
Alex T J Lee 1, 2 , Robin L Jones 2, 3 , Paul H Huang 1
Affiliation  

Pazopanib is the first and only tyrosine kinase inhibitor currently approved for the treatment of multiple histological subtypes of soft tissue sarcoma (STS). Initially developed as a small molecule inhibitor of vascular endothelial growth factor receptors, preclinical work indicates that pazopanib exerts an anticancer effect through the inhibition of both angiogenic and oncogenic signaling pathways. Following the establishment of optimal dosing and safety profiles in early phase studies and approval for the treatment of advanced renal cell carcinoma, pazopanib was investigated in STS. A landmark phase III randomized study demonstrated improved progression-free survival with pazopanib compared to that with placebo in pretreated patients with STS of various subtypes. The efficacy of pazopanib in specific STS subtypes has been further described in real-world-based case series in both mixed and subtype-specific STS cohorts. At present, there are no clinically validated predictive biomarkers for use in selecting patients with advanced STS for pazopanib therapy, limiting the clinical effectiveness and cost-effectiveness of the drug. In this review, we summarize the preclinical and clinical data for pazopanib, outline the evidence base for its effect in STS and explore reported studies that have investigated putative biomarkers.

中文翻译:

帕唑帕尼治疗晚期软组织肉瘤。

帕唑帕尼是目前第一个也是唯一一个被批准用于治疗软组织肉瘤(STS)多种组织学亚型的酪氨酸激酶抑制剂。帕唑帕尼最初是作为血管内皮生长因子受体的小分子抑制剂开发的,临床前研究表明帕唑帕尼通过抑制血管生成和致癌信号通路发挥抗癌作用。在早期研究中确定最佳剂量和安全性并批准治疗晚期肾细胞癌后,帕唑帕尼在 STS 中进行了研究。一项具有里程碑意义的 III 期随机研究表明,在接受过治疗的各种亚型 STS 患者中,与安慰剂相比,帕唑帕尼可改善无进展生存期。帕唑帕尼在特定 STS 亚型中的疗效已在混合和亚型特异性 STS 队列中基于现实世界的病例系列中得到进一步描述。目前,尚无经过临床验证的预测生物标志物可用于选择晚期 STS 患者接受帕唑帕尼治疗,限制了该药物的临床有效性和成本效益。在这篇综述中,我们总结了帕唑帕尼的临床前和临床数据,概述了其在 STS 中的作用的证据基础,并探讨了调查假定生物标志物的已报告研究。
更新日期:2019-11-18
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