2017年美国FDA获批的非小细胞肺癌新药

2018-01-04 佚名 肿瘤资讯

2017年美国FDA在非小细胞肺癌领域批准了5个新适应症和1个新药。其中,靶向药物5个,免疫药物1个。靶向药物EGFR-TKI为三代奥希替尼;另外,ALK抑制剂有3个,分别是:布吉他滨(新药)、色瑞替尼和alectinib;BRAF抑制剂为达拉菲尼和曲美替尼。免疫治疗药物为PD-1抑制剂帕姆单抗。

2017年美国FDA在非小细胞肺癌领域批准了5个新适应症和1个新药。其中,靶向药物5个,免疫药物1个。靶向药物EGFR-TKI为三代奥希替尼;另外,ALK抑制剂有3个,分别是:布吉他滨(新药)、色瑞替尼和alectinib;BRAF抑制剂为达拉菲尼和曲美替尼。免疫治疗药物为PD-1抑制剂帕姆单抗。

从治疗领域看,靶向治疗领域第三代EGFR-TKI奥希替尼用于在一代TKI耐药后存在T790M突变的非小细胞肺癌NSCLC)患者的二线治疗。ALK抑制剂色瑞替尼和alectinib主要用于转移性NSCLC的一线治疗,而布吉他滨用于对一线克唑替尼治疗耐受的NSCLC患者的二线治疗,同时它也是今年FDA批准的唯一一个NSCLC新药。BRAF抑制剂达拉菲尼和曲美替尼用于BRAF-V600E突变的转移性NSCLC患者。免疫治疗领域PD-1抑制剂帕姆单抗再次获得一项一线治疗的适应症,与培美曲塞和卡铂联合用于治疗先前未治疗的转移性非鳞状(NSCLC)的患者。

从2017年FDA在肺癌领域获批的新疗法和药物上看,仍是靶向、免疫各领风骚,化疗似乎正在逐渐退出晚期NSCLC治疗的历史舞台。在靶向药物中不得不提的是给大家带来惊喜的三代TKI药物奥希替尼,2017年批准的适应症是具有T790M突变的NSCLC的二线治疗,其凭借的是在AUAR3研究中将中位无进展时间从化疗的4.4个月提升至10.1个月。接着在今年的公布的FlAURA研究中,奥希替尼冲击一线治疗也大获成功,并且仅用PFS的结果 (18.9个月 VS 10.2个月,HR=0.64, P<0.001)就进入了FDA的加速审评通道。

此外,免疫治疗领域默沙东的帕姆单抗可谓抢尽风头,相比于其竞争对手施贵宝的纳武单抗,率先抢占了晚期非小细胞肺癌免疫一线用药的地位。

总体来讲,肺癌的治疗突破目前仍局限在晚期。但可喜的是,我们的研究者已经开始逐渐将目光放在更早期的患者,比如今年我国知名学者广东省人民医院的吴一龙院长在ASCO上报道的一项将靶向治疗用于肺癌辅助治疗的ADJUVANT研究:对比传统的化疗,一代TKI抑制剂可将患者的中位无病生存时间延长近11个月,之后天津肿瘤医院的王长利教授在世界肺癌大会公布了EVAN研究的初步结果,再次肯定了靶向辅助治疗的获益。目前全球有多项正在进行的靶向药物应用于肺癌辅助治疗领域的临床研究,希望我们明年再来盘点肺癌的新突破时,能够看到更多在早期肺癌治疗中的亮点。

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    2018-01-08 1e145228m78(暂无匿称)

    学习了谢谢作者分享!

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    2018-01-04 神功盖世

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