Chpt 51 中 antineoplastic drugs.pptVIP

抗肿瘤药的分类 一. 直接细胞毒类 (传统抗肿瘤药物) 二. 非直接细胞毒类 1.调节激素平衡药物（雄激素类,雌激素类,糖皮质激素类,抗雌激素,等.） 2. 单克隆抗体（曲妥珠单抗,利妥昔单抗） 3. 信号转导抑制剂（伊马替尼,吉非替尼） 4. 细胞分化诱导剂（维A酸） 5. 细胞凋亡诱导剂（亚砷酸） 6. 新生血管生成抑制剂（重组人血管生成抑制剂） Cancer Therapeutic Modalities Cancer chemotherapy can be curative in certain disseminated neoplasms that have undergone either gross or microscopic spread by the time of diagnosis. These cancers include germ cell cancer, non-Hodgkin’s lymphoma, Hodgkin’s disease, and choriocarcinoma绒(毛)膜癌as well as childhood cancers such as acute lymphoblastic leukemia, Burkitt‘s 伯基特 lymphoma, Wilms tumor 肾母细胞瘤, and embryonal rhabdomyosarcoma横纹肌肉瘤. Anticancer drug development After new drugs with potential anticancer activity are identified, they are subjected to preclinical toxicologic and limited pharmacologic studies in animals. Promising agents that do not have excessive toxicity are then advanced to phase I clinical trials, where in their pharmacologic and toxic effects are usually tested in patients with advanced cancer. Anticancer drug development Ideal anticancer drugs would eradicate cancer cells without harming normal tissues. Unfortunately, no currently available agents meet this criterion, and clinical use of these drugs involves a weighing of benefits against toxicity in a search for a favorable therapeutic index. Importance of Cell Cycle Kinetics An understanding of cell-cycle kinetics is essential for the proper use of the current generation of antineoplastic agents. A cell cycle may be characterized as follows: (1) a presynthetic phase ( G1 ); (2) the synthesis of DNA phase (S); (3) the postsynthetic phase ( G2); (4) mitosis (M) phase. Each of these cells may immediately reenter the cell cycle or pass into a nonproliferative stage, referred to as G0. Importance of Cell Cycle Kinetics Many of the effective anticancer drugs exert their action on cells traversing the cell cycle and are called cell cycle-specific (CCS) drugs. A second group of agents c