狄诺塞麦治疗恶性肿瘤骨转移机制及进展

发布时间：2018-02-15 09:22

本文关键词： 骨转移瘤狄诺塞麦 RANK/RANKL/OPG轴　出处：《重庆医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：骨是实体肿瘤常见的转移部位,骨转移瘤导致的癌痛及骨相关事件(Skeletal related event,SRE),是晚期肿瘤患者生存质量降低,甚至是直接威胁其生存的重要因素。结合目前治疗恶性肿瘤骨转移的现状,其选择繁多,包括药物治疗、放射治疗、手术治疗以及分子靶向治疗,其中放射治疗及手术治疗均为局部对症治疗,而目前临床运用较多的是药物治疗,其中应用较为成熟的是双磷酸盐类,而本文所要讲解的是另外一种分子靶向药物——狄诺塞麦的基础理论及其在临床中的应用(狄诺塞麦即核因子κB受体活化子配体(The receptor activator of nuclear factor kB ligand, RANKL)的单克隆抗体)。在恶性肿瘤骨转移的基础理论中,RANK/RANKL/OPG轴对破骨细胞的激活起关键作用,而狄诺塞麦的分子生物学基础即是阻断该条通路,从而达到阻断骨转移的作用,在增加骨密度(BMD)和延长骨相关事件的首发时间方面目前已取得确切疗效,而对于早期癌症病人预防骨转移似乎也有一定的效果,但目前的研究数据对于我们更为关心的总生存时间的延长并无显著作用,包括其对于预防和治疗肿瘤的作用仍有待于进一步的试验证明,但其对于骨巨细胞瘤的治疗提供了新的选择与希望,虽然目前发尚未成熟,但其前景及效果值得期待。本文主要对狄诺塞麦治疗恶性肿瘤骨转移的机制及其目前的进展作简要的总结。
[Abstract]:Bone is the common metastatic site of solid tumor. The cancer pain caused by bone metastasis and bone related events Skeletal related event SRE, which is the quality of life of patients with advanced tumor, is decreased. Even an important factor that directly threatens their survival. Combined with the current status quo in the treatment of bone metastases from malignant tumors, there are a wide range of options, including drug therapy, radiation therapy, surgical treatment and molecular targeted therapy. Among them, radiotherapy and surgical treatment are local symptomatic treatment, but the current clinical use is more drug treatment, in which the more mature use of bisphosphates, What this paper is going to explain is the basic theory of another kind of molecular targeting drug, Dinosemer, and its clinical application (the receptor activator of nuclear factor kligand, RANKLL), which is the ligand of nuclear factor 魏 B receptor activator. In the basic theory of bone metastasis in malignant tumors, RANKR / RANKL / OPG axis plays a key role in the activation of osteoclasts. However, the molecular biological basis of Dinosemer is to block this pathway, thus blocking bone metastasis, and has achieved a definite effect in increasing bone density and prolonging the onset time of bone related events. And it seems to have some effect on preventing bone metastases in patients with early cancer, but the current research data have no significant effect on the overall survival time that we are more concerned about. Including its role in the prevention and treatment of tumors, which remains to be proved by further trials, but it offers new options and hopes for the treatment of giant cell tumor of bone, although it is not yet mature, But its prospect and effect should be expected. In this paper, the mechanism and current progress in the treatment of malignant tumor bone metastasis with Dinosemer were summarized.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R738.1

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