吉西他滨。综述其在非小细胞肺癌和胰腺癌中的药理学及临床应用潜力。
文章的细节
-
引用
复制到剪贴板 -
Noble S，果阿KL
吉西他滨。综述其在非小细胞肺癌和胰腺癌中的药理学及临床应用潜力。
药物。1997 Sep;54(3):447-72。doi: 10.2165 / 00003495-199754030-00009。
- PubMed ID
-
9279506 (PubMed视图］
- 摘要
-
吉西他滨[2'-脱氧-2'，2'-二氟胞苷单盐酸盐(β异构体);dFdC]是一种新型脱氧胞苷类似物，最初研究其抗病毒作用，但已被开发为抗癌疗法。吉西他滨单药治疗在18 - 26%的晚期非小细胞肺癌(NSCLC)患者中产生了客观的肿瘤反应，似乎与顺铂加依泊苷的疗效相似。当吉西他滨联合顺铂时，客观有效率为26 ~ 54%，治疗后1年生存期为35 ~ 61%。在3项临床试验中，许多接受吉西他滨联合或不联合顺铂治疗的患者出现了一系列NSCLC疾病症状和/或一般性能状态的改善。与NSCLC的最佳支持治疗相比，吉西他滨似乎具有成本效益。此外，根据回顾性成本最小化分析，与吉西他滨单药治疗相关的直接成本可能低于其他一些NSCLC化疗方案。根据一项回顾性成本-效果分析，吉西他滨联合顺铂与顺铂联合依托泊苷或顺铂联合长春瑞滨相比，具有较低的肿瘤反应成本。在一项针对晚期胰腺癌患者的比较研究中，吉西他滨在生存期和一般临床状况方面比氟尿嘧啶更有效。在对氟尿嘧啶难治的患者中也显示出适度的抗肿瘤和姑息疗效。 Gemcitabine appears to be well tolerated, although further comparisons with other chemotherapy regimens are required. The available data indicate that gemcitabine monotherapy is better tolerated than cisplatin plus etoposide in patients with NSCLC. Data from noncomparative studies suggest that the combination of gemcitabine and cisplatin has an acceptable tolerabilty profile. In a single trial in patients with pancreatic cancer, fluorouracil was better tolerated than gemcitabine; however, gemcitabine was generally well tolerated overall in this study. Thus, gemcitabine (with or without cisplatin) may prove attractive to patients with advanced NSCLC, given their limited life expectancy and the toxicity associated with many other chemotherapy regimens. More detailed characterisation of its risk-benefit profile compared with those of current and developing regimens for NSCLC should be possible once results from several ongoing studies are available. Gemcitabine is a valuable new chemotherapy option for patients with advanced pancreatic cancer, a disease considered incurable at present. Its apparent survival and palliative benefits over fluorouracil require confirmation, but are encouraging, as the need to improve both the duration and quality of survival in these patients is well recognised.
