抗肿瘤药物:计划临床前疗效和安全性研究

O. Bezborodova, A. Pankratov, E. Nemtsova, Yu. B. Venediktova, M. Vorontsova, G. N. Engalycheva, R. Syubaev
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引用次数: 2

摘要

DNA结构的解码和新的分子分析方法的发展,以及负责恶性转化的特定基因组变化的鉴定,已经成为针对肿瘤生长的分子和遗传靶点的新型抗肿瘤药物的开发的转折点。从抑制肿瘤细胞增殖的药物的经验筛选过渡到分子靶向分析方法已经提出了一些关于新药临床前评估的严重方法学问题。本文的目的是分析不同类型的现代抗肿瘤药物临床前疗效和安全性研究的一般原则和特点,以期改进现有的国家指南。本文综述了不同类别抗肿瘤药物(小分子化疗药物、激素和激素拮抗剂、烷基化剂和抗代谢药物、微生物和草药以及单克隆抗体)的临床前研究的各个方面。本文探讨了研究药物在体内、体外和体外药理活性以及评价其药代动力学参数的一般原理。它描述了各种研究方法和模型,总结了各种药物的遗传毒性、致癌性、生殖毒性、诱变性、急性和慢性毒性测定的具体方面。它还列出了为毒性动力学研究选择药物剂量的标准。需要将开展临床前研究的国家要求与欧洲标准统一起来,这就需要对术语进行统一,并进一步开发用于选择剂量和确定必要研究范围的通用算法。在临床前研究中使用生物标志物将有可能从进一步的研究中排除效率低下的化合物。
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Anti-Tumour Drugs: Planning Preclinical Efficacy and Safety Studies
The decoding of the DNA structure and development of new molecular methods of its analysis, as well as identification of specific genomic changes responsible for malignant transformation, have become the turning points in elaboration of novel anti-tumour drugs directed against molecular and genetic targets of tumor growth. Transition from empirical screening of agents inhibiting tumour cell proliferation to molecule-targeted analytical methods has raised a number of serious methodological issues regarding preclinical evaluation of novel medicines. The objective of this paper was to analyse general principles and features of preclinical efficacy and safety studies of different classes of modern anti-tumour drugs with a view to improve existing national guidelines. The paper reviews various aspects of preclinical studies of different classes of anti-tumour drugs (small molecule chemotherapy drugs, hormones and hormone antagonists, alkylating agents and antimetabolites, microbial and herbal medicines, as well as monoclonal antibodies). The article explores general principles of studying the drugs’ pharmacological activity in vitro, ex vivo, and in vivo, and evaluating their pharmacokinetic parameters. It describes various methods and models of research, summarises specific aspects of determination of genotoxicity, carcinogenicity, reproductive toxicity, mutagenicity, acute and chronic toxicity of various groups of medicines. It also lists criteria for selecting drug doses for toxicokinetic studies. The need for harmonisation of national requirements for conducting preclinical studies with the European standards entails alignment of terminology and further development of general algorithms for selecting doses and determining the necessary scope of research. The use of biomarkers in preclinical studies will make it possible to exclude inefficient compounds from further research.
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