Авастин в клинической химиотерапии злокачественных опухолей

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Аннотация

Авастин (бевацизумаб) – гуманизированное моноклональное антитело, обладающее выраженной антиангиогенной активностью, прицельно блокирующее сосудистый эндотелиальный фактор роста VEGF и предотвращающее его связывание с рецепторами. Хронологически Авастин является одним из первых (вторым после трастузумаба) таргетных препаратов, разрешенных для применения в клинической практике. Также он является единственным таргетным препаратом, применяемым при основных злокачественных солидных опухолях: метастатическом колоректальном раке, местно-рецидивирующем или метастатическом раке молочной железы, местно-распространенном, метастатическом или рецидивирующем неплоскоклеточном немелкоклеточном раке легкого, распространенном и/или метастатическом почечно-клеточном раке, глиобластоме (глиома 4-й степени злокачественности по классификации Всемирной организации здравоохранения) и эпителиальном раке яичника, маточной трубы и первичном раке брюшины. Таким образом, в результате многочисленных исследований Авастина в онкологии, проведенных в течение более 10 лет, Авастин можно охарактеризовать сегодня двумя словами: первый и лучший, поскольку ни один таргетный препарат не нашел столь широкого клинического применения и показаний в практической онкологии, и, более того, практически ни одно клиническое исследование Авастина не было безуспешным. Следует сказать также, что большой клинический опыт показывает относительную безопасность препарата в различных подгруппах и популяциях больных.

Ключевые слова: Авастин, ангиогенез, эндотелиальный фактор роста сосудов, таргетные препараты, колоректальный рак, рак молочной железы, немелкоклеточный рак легкого, почечно-клеточный рак, глиобластома, рак яичников, рак фаллопиевой трубы, первичный рак брюшины.

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Avastin (bevacizumab) is a humanized monoclonal antibody with evident antiangiogenic activity, which blocks vessel endothelial growth factor (VEGF) and prevent its binding with receptors. Chronologically Avastin was among the first (second after trastuzumab) targeted agents approved for clinical practice. Also it is the only targeted agent used in the main malignant solid tumor types: metastatic colorectal cancer, locally recurrent or metastatic breast cancer, metastatic or recurrent nonsquamous non-small cell lung cancer, advanced and/or metastatic renal cell cancer, glioblastoma (stage IV glioma according to WHO classification) and epithelial ovarian, fallopian tube, or primary peritoneal cancer. Therefore Avastin can be defined today as the first and the best, because not one targeted agent has so wide clinical use and indications in practical oncology and moreover practically there were no ineffective clinical trials with Avastin. Also it is necessary to mention that large clinical experience with Avastin demonstrates comparative safety of the agent in different patient’s subgroups and populations.

Key words: Avastin, angiogenesis, vessel endothelial growth factor, targeted agents, colorectal cancer, breast cancer, non-small cell lung cancer, renal cell cancer, glioblastoma, ovarian cancer, fallopian tube cancer, primary peritoneal cancer.

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Авторы

В.А.Горбунова

ФГБУ Российский онкологический научный центр им. Н.Н.Блохина РАМН, Москва

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V.A.Gorbunova

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