血管内皮生长因子抑制剂在胆管细胞癌治疗中的应用进展

doi:10.3969/j.issn.1006-5725.2024.24.019

Abstract

Abstract:

Cholangiocarcinoma （CCA） is an aggressive malignant tumor originating from bile duct epithelial cells， characterized by a poor prognosis. Surgery is the primary treatment， but late diagnosis often leads to poor surgical outcomes. Consequently， patients typically rely on comprehensive treatment such as chemotherapy. However， the median survival remains short， highlighting the urgent need for new strategies. Vascular endothelial growth factor （VEGF）， a crucial factor in angiogenesis， is frequently overexpressed in tumor cells of CCA patients. Recent studies have shown that VEGF not only promotes angiogenesis but also exacerbates the invasion and metastasis of CCA. Therefore， targeting VEGF-mediated angiogenesis provides a new strategy for treating CCA. VEGF inhibitors represent a new frontier in CCA treatment， offering opportunities for precision therapy. By integrating VEGF inhibitors with immunotherapy and chemotherapy， it is possible to not only effectively prolong the survival of CCA patients but also to offer new hope for improving their quality of life. This review examines the expression of VEGF in CCA， its role in tumorigenesis， and the clinical application of VEGF inhibitors in treating CCA.

Key words: cholangiocarcinoma, inhibitors, VEGF

CLC Number:

R735.8

Jianfang ZHANG,Xueqin SUN,Yeqian CUI,Yang CHEN,Shaobo. WANG. Effects of VEGF inhibitors for treating cholangiocarcinoma： A review of literature[J]. The Journal of Practical Medicine, 2024, 40(24): 3554-3560.

Figures/Tables 1

References 70

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药物分类	作用机制	代表药物	作用特点	不良反应
单克隆抗体	特异性地结合并中和VEGF或同源受体，阻断其与受体的结合，从而减少肿瘤异常血管生成	Bevacizumab	能延长患者PFS，但不能延长OS	单一疗法临床效果差，会出现难以避免的并发症（可能会抑制生理性血管的生成）
单克隆抗体	特异性地结合并中和VEGF或同源受体，阻断其与受体的结合，从而减少肿瘤异常血管生成	Ramucirumab	耐药性良好，能延长晚期以及难治性CCA患者的中位PFS	单一疗法临床效果差，会出现难以避免的并发症（可能会抑制生理性血管的生成）
酪氨酸激酶抑制剂	抑制VEGF受体的TK活性来阻断VEGF信号传导，有效抑制血管生成，减少血管通透性，从而阻断肿瘤细胞的增殖并促进其凋亡	阿帕替尼	阻断CCA中VEGF通路而影响肿瘤细胞的增殖、迁移和侵袭	伴随反应，如高血压、蛋白尿、出血、血胆红素升高、血栓等
		舒尼替尼	缓解晚期CCA，还具有良好的耐受性和较小的不良反应
		安罗替尼	新型多靶点抑制剂；抑制VEGF信号通路传导和磷酸化水平失活、阻滞细胞周期；3级或更高不良反应发生率显著降低（相较于舒尼替尼）
		索拉非尼	抑制多种信号通路，单独用于治疗晚期CCA患者效果不理想
RNAi疗法	特异性地降低或沉默VEGF基因的表达来抑制其生物学活性	Macugen	用于糖尿病性黄斑水肿	递送效率低、体内稳定性差；可能引起宿主的免疫反应；脱靶效应
RNAi疗法	特异性地降低或沉默VEGF基因的表达来抑制其生物学活性	Onpattro、Givlaari、Oxlumo、Leqvio和ALN-HSD	作用于肝脏疾病的5种获批药物	递送效率低、体内稳定性差；可能引起宿主的免疫反应；脱靶效应

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Effects of VEGF inhibitors for treating cholangiocarcinoma： A review of literature

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