抗血管新生治療於非小細胞肺癌之應用

Angiogenesis Inhibitors for the Treatment of Non-Small Cell Lung Cancer

對於腫瘤生長及轉移而言，「血管新生」是一個重要的環節。Bevacizumab是一種拉血管內皮生長因子（vascular endothelial growth factor, VEGF）的單株抗體，於第一線治療時與paclitaxel及carboplatin合併使用，是目前唯一被核准用於非小細胞肺癌的抗血管新治療藥物。血管激酶抑制劑是小分子口服藥，除抑制血管內皮生長因子路徑（VEGF pathway）外，也同時抑制其他與血管新生相關的訊息傳導路徑，如血小板衍生生長因子路徑（platelet-derived growth factor, PDGF pathway）以及纖維母細胞生長因子路徑（fibroblast growth factor, FGF pathway）等。數種血管激酶抑制劑已經或正在被研究於非小累胞市癌之治療。在這段文章中，我們將回顧「抗血管新生治療」於非小細胞肺癌的發展現況及未來展望。

Angiogenesis is an essential component of tumor growth and metastasis. To date, an anti-vascular endothelial growth factor (VEGF) antibody, bevacizumab, in combination with paclitaxel and carboplatin in first-line setting is the only approved anti-angiogenic treatment in non-small cell lung cancer (NSCLC). Angiokinase inhibitors are oral small molecular agents. They not only inhibit the VEGF pathway, but also target other important signaling pathways contributing to angiogenesis, the platelet-derived growth factor and fibroblast growth factor pathways. Several angiokinase inhibitors have been studied or are in investigations for treatment of NSCLC, and we review the current developmental status and future perspectives of these inhibitors (including sorafenib, sunitinib, motesanib, nintedanib) in NSCLC.