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　　“全国肿瘤防治宣传周”专题

"The national cancer prevention and control publicity week"project

　　此类药也有明确的治疗适应症，有“敏感”的靶点才能起效

此类药也There are明确的治疗适应症,There are"sensitive"Target to work

　　4月15日～21日是全国肿瘤防治宣传周。近十年来，靶向治疗的科研和临床似乎已经超越了所有肿瘤研究的风头，学术推广和商业营销一浪高过一浪，推出新药的速度和临床运用的数量史无前例的高涨。专家提醒：此类药物也有明确的治疗适应症，也可存在耐药性和毒副作用等问题，莫将其当作救命“神药”盲目滥用，以免最后落得“人财两空”。

4月15日～21日是The national cancer prevention and control publicity week.In nearly a decade,Targeted therapy of scientific research and clinical cancer research, seem to have transcended all thunder,Wave upon wave of academic promotion and business marketing,Launch the speed of the new drug and clinical use of the number of unprecedented upsurge.The expert reminds:There are clear indications for the treatment of such drugs,Also some problems such as drug resistance and side effects,He will as it for help"God medicine"Blindly abuse,In order to avoid the last end up"The goods".

　　文/记者翁淑贤 通讯员陈壮忠、张秋霞、高三德

文/记者翁淑贤 通讯员陈壮忠/Zhang Qiuxia/High SanDe

　　医学指导/广州中医药大学第一附属医院大肿瘤科林丽珠教授、广州市中医医院肿瘤科张华教授

医学指导/广州中医药大学第一附属医院大肿瘤科林丽珠教授/The guangzhou hospital of traditional Chinese medicine oncology professor zhang hua

病例： cases:

　　靶向药吃几个月后失效了 靶向药吃几个月后失效了

　　74岁的何婆婆体检时查出右上肺中央型肺腺癌。家人听说靶向药物是目前最好的治癌药，比起化疗来毒副作用小，就主张让何婆婆吃靶向药。为了让老人用上“最好”的药，他们还托人到香港、美国去买。一开始吃了靶向药，何婆婆的病情控制得还好，但几个月后就不行了，甚至频频出现头晕头痛、胸闷气促等症状，到医院检查发现肿瘤已经脑转移，并出现大量的胸腔积液。

74岁的何婆婆体检时查出右上肺中央型肺腺癌.His family heard drug targeted drugs is the best cure of cancer,Small compared to the chemotherapy side effects,That let's mother-in-law to targeted drugs.In order to let the old man"The best"The medicine,They also ask to Hong Kong/The United States to buy.A began to eat the targeted drugs,What her mother-in-law was also well control,But after a few months,Even frequently appear dizziness have a headache/Chest short breath and other symptoms,To go to the hospital inspection found that tumors have brain metastases,And there a lot of pleural effusion.

　解读： Interpretation of the:

　　靶向药物也有耐药性 靶向药物Also there is resistance

　　“临床上不少使用靶向药物的患者服用一段时间后失效便会产生各种各样的困惑。”广州中医药大学第一附属医院大肿瘤科主任林丽珠教授介绍，“其实，大多数药物都会产生耐药性，包括靶向药物在内。”林丽珠解释称，分子靶向药物是通过抑制肿瘤细胞的生长，最后使其死亡来达到治疗目的的。各种特定的分子靶向药物是针对某种癌细胞的某一个蛋白、某一个分子起作用的，只能抑制肿瘤生长的一条通路而已。当一条通路受到抑制时，肿瘤细胞会不断自寻“生路”，选择其他通路合成自身生长所需要的物质，久而久之可使分子靶向药物失去作用，即产生耐药性。例如，治疗肺癌的靶向药物TLI抑制剂的中位有效期是9~13个月，基本上每个病人迟早都会出现耐药。

"Many clinical use of targeted drugs patients taking the failure after period of time will produce all kinds of confusion."The first affiliated hospital of guangzhou university of Chinese medicine professor Lin Lizhu director big oncology is introduced,"In fact,Most drugs will become resistant,Including targeted drugs."Lin Lizhu explains,Molecular targeted drugs is by inhibiting the growth of tumor cells,Finally make its death can achieve the goal of treatment.Specific molecular targeted drugs for some cancer cells of a protein/A certain molecules play a role,Of a path can inhibit tumor growth.When one pathway is restrained,Tumor cells will continue to anticipate"Chance to live",Choose other pathways in synthetic substances necessary for growth,As time passes can make the molecular targeted drugs,The resistance.Such as the,Targeted therapy of lung cancer drugs TLI inhibitors in the period of validity is 9 ~ 13 months,Basically, each patient appear resistant sooner or later.

　　另一个常见的困惑是：为什么患同一种病，服用同样一种药，有的人有效，有的人却无效？对此，林丽珠表示，对于特定的靶向药物，使用前应做相关的基因检测，弄清楚患者体内的肿瘤细胞上是否有符合相关靶向药物“打击”的位点。有了“敏感”的靶点，药物才能起效。另外，靶向药物在肿瘤的治疗中是前进了一步，但仍然有许多未知的因素制约着它的发展，因此，即使起效后也可能由于各种复杂的原因而失效。

另一个常见的困惑是:Why have the same kind of disease,Is also a kind of drugs,Some effective,Some people are invalid?For this,Lin Lizhu said,For a specific targeted drugs,Before use should be related to genetic testing,Understand the patient's body whether have to comply with relevant targeted drugs on cancer cells"blow"Of the site.There are a"sensitive"The target of,Medicines can work.In addition,Targeted agents in the treatment of tumor is a step forward,But there are still many unknown factors restricting its development,so,Even after work may also fail due to various complicated reasons.

提醒： remind:

　　滥用靶向药小心人财两空 滥用靶向药小心The goods

　　广州市中医医院肿瘤科张华教授坦言，近十年来，靶向治疗的科研和临床似乎已经超越了所有肿瘤研究的风头，学术推广和商业营销一浪高过一浪，推出新药的速度和临床运用的数量史无前例的高涨。

The guangzhou hospital of traditional Chinese medicine oncology professor zhang hua坦言,In nearly a decade,Targeted therapy of scientific research and clinical cancer research, seem to have transcended all thunder,Wave upon wave of academic promotion and business marketing,Launch the speed of the new drug and clinical use of the number of unprecedented upsurge.

　　张华指出，目前国内对靶向药物的使用已出现滥用的苗头，有医生方面对适应症把握不严的原因，临床上有不少该做的基因检测没认真做便随便用药的例子；另一方面，病人自身受某些药商夸大宣传的影响，将其当作救命“神药”，对疗效寄以过高的期望。事实上，目前国内外大量临床研究证实，使用分子靶向药物，患者的用药缓解率为20%~50%，中位生存期延长5~15个月。但靶向药物是癌症药物中最昂贵的，病人服用一个月花费常需数万元。受癌症折磨的家庭到最后病急乱用药的现象并不少见，甚至抱着“死马当活马医”的想法，砸锅卖铁，钱花了不少，药用了却没多大效果，最后落得人财两空。

张华指出,At present, the domestic use of targeted drugs has appeared signs of abuse,What are the doctors of indications is lax,Clinically many genetic tests to do not do casual drug use of examples;On the other hand,A patient's own affected by certain drug exaggerated publicity,As a help"God medicine",The curative effect with high expectations.In fact,,At home and abroad a large number of clinical studies,Using the molecular targeted drugs,Patients' medical relief rate was 20% ~ 50%,The median survival period extended 5 ~ 15 months.But targeted drugs is the most expensive cancer drugs,Patients taking cost often need tens of thousands of yuan a month.Tortured by cancer family until the last critical illness of using medicineatwill phenomenon is not uncommon,Even holding the"Dead horse move. The"The idea of,saucepans,Spent a lot of money,Medicinal live to little effect,Finally got the goods.

　　“客观来讲，这类药物对适用的人群能起到一定的治疗作用，但并非像某些夸大宣传所吹嘘的那样安全有效。”张华告诉记者，靶向药物的滥用不仅已经影响了癌症病人的规范治疗和基本治疗，还会拉低分子靶向药物本身的疗效，并增加其副作用。他就诊治过因为靶向治疗药物造成的肺纤维化和心功能衰竭等严重副作用的病人，皮疹、恶心、呕吐和腹泻等发生率也并不低。

"To be fair,This kind of drugs for the treatment of applicable people can play a role,But it is not like some exaggerated propaganda's vaunted is safe and effective."Zhang hua told reporters,Targeted drugs of abuse has not only affected the standard treatment and basic care of cancer patients,Will pull the curative effect of low molecular targeted drugs itself,And increase its side effects.He was treated for targeted therapy drugs cause of pulmonary fibrosis and cardiac failure and other serious side effects of the patients,The rash/nausea/Incidence of vomiting and diarrhea is not low.