Resistance of ovarian cancer treatment strategy

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Tumor resistance of the tumor cells to anticancer drugs that showed no reaction of the state of ovarian cancer chemotherapy failure is the central link.

In the cell level can be divided into the inherent resistance of resistance and acquired resistance of the two. Acquired resistance of ovarian cancer is the main reason for resistance. Resistance of ovarian cancer treatment at the following categories of major new strategy.

; To detoxification pathway-based chemotherapy

1. Resistance

In ovarian cancer, the majority of tumors, glutathione S-transferase enzyme expression. Many in vivo antitumor drugs produced primarily by reactive oxygen species and lipid peroxidation to kill tumor cells, and glutathione S-transferase enzyme can remove these reactive oxygen species and lipid peroxidation, interference drugs on the destruction of tumor cells, resulting in tumor cell resistance.

2. Representatives of drug

Telcyta is a way of relying on the antitumor drugs, and its decomposition products with glutathione S-transferase combined inhibition of tumor cell resistance, the tumor cells with DNA, RNA and protein in response to anti-tumor cells.

The drug did not kill normal cells, small toxicity.

Initially, the combination of telcyta visibility, and the treatment of platinum-resistant ovarian cancer, 68% of the patients were eased. An ongoing multi-center clinical trials show that single-drug treatment can telcyta 50% of patients with stable, low-dose and high-dose groups of patients with Telcyta remission rates were 15% and 19%. A number of Phase II clinical trials show that telcyta alone or with other drugs in the treatment of ovarian cancer significant effect, the drug has entered Phase III clinical trials.

To apoptosis pathway-based chemotherapy

1. Resistance

Patients with ovarian cancer in the body of AKT and a number of factors can stimulate the activation of MAPK and NF-kappa-axis B pathway, inhibition of apoptosis and reduce the efficacy of chemotherapy drugs.

2. Representatives of drug

17-AAG is a representative enhanced apoptosis of the anticancer drug, it can promote the proteasome degradation of misfolded heat shock protein (Hsp) 90, and then inhibited cell growth and induced apoptosis, plays the anti-tumor effect.

PS341 is another pathway based on the antitumor drugs, can reversibly inhibiting proteasome activity, affect NF-kappa B activation, the Bcl-2 antagonist-induced apoptosis of cells, thus inducing apoptosis of tumor cells, the production of anti-tumor effect.

At present, as a unique anti-tumor effects of new drugs, 17-AAG and PS341 blood being used in a variety of systems and the treatment of solid tumor clinical trials.

The growth factor and signal transduction pathway for the

Based Chemotherapy

1. Mechanism

The use of epidermal growth factor analogue to epidermal growth factor receptor targeted play antitumor effect.

2. Representatives of drug

Gefitinib and erlotinib are listed on such FDA approved new anti-tumor drugs, which alone or combined with other drugs, can be used for platinum category, or paclitaxel-resistant ovarian cancer treatment, has entered Phase II clinical trials, but two of the efficacy of single agent are poor.

Chemotherapy drug sensitivity and tolerance analysis

1. Experimental Methods

Now the international community can be applied to multi-drug chemotherapy sensitivity and tolerance analysis to guide experimental resistant ovarian cancer treatment. This method is mainly from patients with ovarian cancer tumor cells in vitro incubation with the common chemotherapy drugs, access to the collection of individual tumor cells to chemotherapeutic drug reaction information, thereby choosing sensitive drug treatment.

2. Clinical trials

Gallion, 371 cases of peritoneal cancer and ovarian cancer patients with chemotherapy drug sensitivity and tolerance analysis experiment. According to test results, patients were divided into three groups and sensitivity to drugs, drug moderate sensitivity and tolerance of drug treatment, 135 cases of patients eventually accepted the monitoring and follow-up.

Results show that the risk of tumor progression, sensitivity drug treatment group, moderate sensitivity drug treatment group and tolerance of drug treatment group were higher, and tumors were no progress in shortening the period. Researchers believe that chemotherapy sensitivity and tolerance analysis can be used for patients with ovarian cancer tumor progression interval of time forecast for the clinical treatment provide useful guidance to improve the resistance of ovarian cancer treatment.

3. Advantages and disadvantages

American Memorial Sloan-Kettering Cancer Center Aghajanian, that the resistance of ovarian cancer drug treatment options, based mainly on traditional physician's experience or even the preferences of patients, the use of reasonable methods to prevent such acts of blind and lower toxicity, and is slowing the progression of progress second-line drug for treatment, allowing patients to achieve better results. Therefore, chemotherapy sensitivity and tolerance analysis, could be considered as a routine clinical testing indicators.

Of course, this method has not yet standardized, failing to clear the primary tumor and metastases, without chemotherapy and tumor tissue after chemotherapy results of the analysis of the similarities and differences; Clinicians subjective prefer patients with tumors larger material for analysis, the prognosis is poor accordingly, but this was the conclusions and not pushed to such non-patients.

In short, more resistant to the drugs and methods of treatment of ovarian cancer has brought new hope, I believe that with the emergence of new drug candidates as well as new methods of application, resistant ovarian cancer treatment will be even brighter prospects.

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