吉西他滨。回顾其药理学和临床潜力在非小细胞肺癌和胰腺癌。
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高贵的年代,果阿吉隆坡
吉西他滨。回顾其药理学和临床潜力在非小细胞肺癌和胰腺癌。
药。1997年9月,54 (3):447 - 72。doi: 10.2165 / 00003495-199754030-00009。
- PubMed ID
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9279506 (在PubMed]
- 文摘
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吉西他滨(2 ' -deoxy-2 ', 2 ' -difluorocytidine monohydrochloride(β异构体);dFdC)是一种新型脱氧胞苷类似物最初是追究其抗病毒作用,但已经开发作为抗癌治疗。吉西他滨单药治疗产生客观肿瘤反应在18 - 26%的晚期非小细胞肺癌(NSCLC)患者,似乎也有类似的功效,顺铂+依托泊苷。客观反应率从26 - 54%记录吉西他滨与顺铂相结合时,和1年期等治疗后生存时间范围从35 - 61%。改善非小细胞肺癌的疾病症状和/或一般性能状态发生在许多患者接受吉西他滨,有或没有顺铂,3例临床试验。吉西他滨似乎是最好的支持性护理成本效益而非小细胞肺癌。此外,吉西他滨单药治疗的直接成本与管理可能会低于其他非小细胞肺癌的化疗方案,根据回顾cost-minimisation分析。吉西他滨+顺铂的组合与每肿瘤反应成本低于顺铂+依托泊苷或顺铂+ vinorelbine,据回顾成本效益分析。在一个比较研究在晚期胰腺癌患者,吉西他滨是更有效的比氟尿嘧啶对生存时间和一般临床状态。它还显示适度抗肿瘤和姑息功效病人耐火氟尿嘧啶。 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.
