中国癌症杂志 ›› 2021, Vol. 31 ›› Issue (8): 754-761.doi: 10.19401/j.cnki.1007-3639.2021.08.009

• 综述 • 上一篇    下一篇

Trastuzumab deruxtecan的临床研究进展及展望——HER2耐药患者的新希望

朱逸晖,李 婷,胡夕春   

  1. 复旦大学附属肿瘤医院肿瘤内科,复旦大学上海医学院肿瘤学系,上海 200032
  • 出版日期:2021-08-30 发布日期:2021-09-03
  • 通信作者: 胡夕春 E-mail: xchu2009@hotmail.com

Clinical research progress and prospect of trastuzumab deruxtecan

ZHU Yihui, LI Ting, HU Xichun   

  1. Department of Medical Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
  • Published:2021-08-30 Online:2021-09-03
  • Contact: HU Xichun E-mail: xchu2009@hotmail.com

摘要: 新型抗体药物偶联物(antibody-drug conjugate,ADC)trastuzumab deruxtecan(以下称为DS-8201a)是人表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)靶向抗体和DNA拓扑异构酶Ⅰ抑制剂德卢替康(deruxtecan,DXd)的结合物。DS-8201a具有荷载新型细胞毒性药物、高药物抗体比例和较高细胞膜通透性等特征,较传统抗HER2药物只针对HER2过表达患者相比,对于HER2过表达或低表达的肿瘤皆可发挥作用。迄今已在乳腺癌、胃癌、结直肠癌和非小细胞肺癌等多种实体瘤中开展Ⅰ~Ⅲ期临床试验,研究包括适应证、药物毒性与安全性、有效剂量的确定、与现有一线及后线多种标准化疗方案的疗效比较、单药与联合用药的疗效比较等,均显示出良好效果,可能为临床治疗HER2过表达或低表达肿瘤提供新的治疗方法,使用时需监测肺部症状。概述DS-8201a的药物结构特点及相关临床研究进展。

关键词: HER2, 抗体药物偶联物, 乳腺癌, 胃癌, 非小细胞肺癌, 靶向治疗

Abstract: Trastuzumab deruxtecan (DS-8201a) is a novel antibody-drug conjugate (ADC) of human epidermal growth factor receptor 2 (HER2) targeted antibody and DNA topoisomerase Ⅰ inhibitor (deruxtecan, DXd). DS-8201a has the characteristics of loading new cytotoxic drugs, high proportion of drug antibodies and high cell membrane permeability. Compared to traditional anti-HER2 drugs only aimed at patients with overexpression of HER2, DS-8201a can also play a role in tumors with high and low expressions of HER2. So far, phase Ⅰ to Ⅲ clinical trials have been carried out in a variety of solid tumors, such as breast cancer, gastric cancer, colorectal cancer and non-small cell lung cancer. Studies have shown results, including indications, toxicity and safety, determination of effective dose, comparison with existing first-line and posterior-line standard chemotherapy regimens, and efficacy comparison between monotherapy and combination therapy. It may provide a new therapeutic method for clinical treatment of tumors with overexpression or low expression of HER2, and pulmonary symptoms should be monitored during use. In this review, the drug structure characteristics, related clinical research progress and prospect of DS-8201a were summarized.

Key words: Human epidermal growth factor receptor 2, Antibody-drug conjugate, Breast cancer, Stomach cancer, Non-small cell lung cancer, Colorectal cancer