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Advances in antiangiogenic treatment of small-cell lung cancer

机译:小细胞肺癌抗血管生成治疗研究进展

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Small-cell lung cancer (SCLC), a poorly differentiated neuroendocrine malignancy, has a rapid growth rate, strong aggressiveness, early metastases, and poor prognosis. Angiogenesis greatly contributes to the metastatic process of SCLC, which has a higher vascularization compared with non-small-cell lung cancer (NSCLC). SCLC might constitute an ideal malignancy for assessing new antiangiogenic drugs and therapeutic strategies. Combining bevacizumab with paclitaxel has therapeutic benefits in chemoresistant, relapsed SCLC. The cisplatin–etoposide and bevacizumab combination, as the first-line treatment for extensive-stage SCLC, can improve progression-free survival (PFS), with an acceptable toxicity profile. Ziv-aflibercept combined with topotecan is promising for platinum-refractory SCLC. Chemotherapy combined with thalidomide cannot prolong survival. Maintenance sunitinib of 37.5 mg/day in extensive-stage SCLC patients following induction chemotherapy with platinum/etoposide improves median PFS by 1.6 months. Serum angiopoietin-2 concentrations and vascular endothelial growth factor levels correlate with poor prognosis. Bevacizumab, ziv-aflibercept, and sunitinib are worthy of further evaluation. Thalidomide, sorafenib, pomalidomide, and cediranib may not be suitable for SCLC.
机译:小细胞肺癌(SCLC)是分化程度低的神经内分泌恶性肿瘤,具有生长速度快,侵略性强,早期转移和预后差的特点。血管生成极大地促进了SCLC的转移过程,与非小细胞肺癌(NSCLC)相比,SCLC的血管化更高。 SCLC可能构成评估新的抗血管生成药物和治疗策略的理想恶性肿瘤。贝伐单抗与紫杉醇联合使用对化疗耐药的复发性SCLC具有治疗作用。顺铂-依托泊苷和贝伐单抗联合使用,作为广泛期SCLC的一线治疗,可以改善无进展生存期(PFS),并具有可接受的毒性。 Ziv-aflibercept联合拓扑替康有望用于难治性铂类SCLC。化学疗法联合沙利度胺不能延长生存期。在铂/依托泊苷诱导化疗后,广泛期SCLC患者维持舒尼替尼37.5 mg /天,可使中位PFS提高1.6个月。血清血管生成素2浓度和血管内皮生长因子水平与不良预后相关。贝伐单抗,ziv-aflibercept和舒尼替尼值得进一步评估。沙利度胺,索拉非尼,泊马利度胺和西地尼布可能不适用于SCLC。

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