Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2006, vol. 15, nr 6, November-December, p. 1107–1112

Publication type: review article

Language: English

Advances in Targeted Therapy of Non−Small Cell Lung Cancer

Postępy w terapii celowanej niedrobnokomórkowego raka płuca

Marcin Gołecki1,

1 Chair and Department of Pulmonology and Lung Neoplasms, Silesian Piasts University of Medicine, Wrocław, Poland

Abstract

Lung cancer is the most common neoplasm in Poland and in the word, 80% cases of which are non−small cell lung cancer (NSCLC). The effects of its therapy are unsatisfactory. In Poland 5 – years survival does not exceed 10%. Most patients die from distant metastases. Chemotherapy – the only so far known systemic way to slow the disease – has both: very limited efficacy and very high toxicity. This article describes an entirely new therapy in NSCLC, which is based on the latest developments in molecular biology, called targeted therapy. The article especially focuses on the role of EGFR receptors and methods of their inhibition with tyrosine kinase inhibitors (gefitinib, erlotinib) and monoclonal antybodies (cetuximab). Also mechanisms of angiogenesis are described along with the possibility of their down regulation by bevacizumab. Described currant advances in targeted therapy of cancer (including NSCLC) bring real hope for treatment improvement.

Streszczenie

Rak płuca jest najczęstszą chorobą nowotworową w Polsce i na świecie. 80% przypadków to niedrobnokomórkowy rak płuca (n.d.r.p.). Wyniki leczenia są złe. 5 lat przeżywa w Polsce nie więcej niż 10% chorych. Większość z nich umiera z powodu przerzutów. Dotychczas stosowane leczenie systemowe, chemioterapia, ma bardzo ograniczoną skuteczność oraz charakteryzuje się znaczną toksycznością. Artykuł opisuje nowy sposób leczenia systemowego n.d.r.p. – tzw. terapię celowaną, opierającą się na najnowszych osiągnięciach biologii molekularnej. Szczegółowo omówiono rolę receptorów EGFR oraz możliwości ich zablokowania za pomocą inhibitorów kinaz tyrozynowych (gefitynib, erlotynib) oraz przeciwciał monoklonalnych (cetuksymab). Omówiono również zjawisko angiogenezy nowotworowej i wyniki jej hamowania za pomocą bewacyzumabu. Postępy w terapii celowanej nowotworów, w tym n.d.r.p., dają nadzieję na poprawę wyników leczenia tej grupy chorób. Słowa klucze: niedrobnokomórkowy rak płuca, terapia celowana, ERB B, EGFR, VEGF, angiogeneza.

Key words

non−small cell lung cancer, targeted therapy, ERB B, EGFR, VEGF, angiogenesis

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