Targeted drugs are effective and have few side effects. Why don’t doctors give them to every cancer patient? Here comes the truth

Everyone talks about cancer. According to the latest statistics from the National Cancer Center, there were 828,000 new cases of lung cancer in China in 2016, and the death toll was as high as 657,000. Lung cancer is the malignant tumor with the largest number of deaths in China, with more than 1,800 people dying every day. Died from lung cancer, just 30 seconds after you read a paragraph of text, one person was killed by lung cancer.

How to develop new anti-cancer drugs with better effect and higher cost-effectiveness is an urgent priority. A recent new drug, Ribotinib, may give cancer patients new hope.

1. Ribotinib: The tumor disappeared completely, and the new anti-cancer drug has a gratifying effect

Ribotinib It is a new multi-targeted drug and a new-generation kinase inhibitor targeting non-small cell lung cancer, advanced solid tumor ROS1 and NTRK oncogenic factors.

In 2021, Ribotinib set an extraordinary record at the World Oncology Congress. The objective response rate can reach 93% in different stages, and there is one patient in the middle of complete response (all target tumor lesions disappeared, no new lesions appeared, and tumor markers remained normal for at least 4 weeks).

On April 28 this year, the efficacy of rebotinib in Chinese patients was published for the first time, in all 4 patient cohorts treated. Positive top line results. For example, in the cohort of newly treated ROS1-positive patients, a total of 71 patients with non-small cell lung cancer participated, and the overall objective response rate reached 79%. There were 11 patients from China who had an objective response rate. The rate has reached 91%!

Such a high response rate is exciting for the medical community, and the good news about rebotinib doesn’t stop there, it’s not just for lung cancer, but for some other Tumors also have therapeutic effects.

Second, not only effective for lung cancer, Ribotinib can kill a variety of tumors

1. Broad spectrum, killing a variety of tumors Tumors

Ribotinib has been granted breakthrough therapy designation by the FDA for the treatment of patients with advanced solid tumors carrying NTRK gene fusions, and was approved by the China Drug Administration this year The Agency granted Breakthrough Therapy for TKI-naïve ROS1-positive non-small cell lung cancer. That is to say, patients with advanced solid tumors clinically carrying NTRK and ROS1 gene fusions can theoretically be treated with rebotinib.

2. Good tolerance and mild adverse reactions

Ribotinib has good efficacy and Tolerability, the main adverse events are mostly grade 1~2, the common ones include dizziness, fatigue, constipation, dyspnea and dyspepsia, etc., no serious grade 4~5 has been found during the treatment. of adverse events.

3. Excellent resistance to drug resistance

For some patients who have not received ROS1 inhibitor therapy, but received one or more ROS1 inhibitor therapy The overall response rate of patients can reach 40~86%.

In the past, clinical trials of Ribotinib were carried out abroad, and many patients in my country did not have the opportunity to receive the drug. But since last year, my country has also started clinical trials of Ribotinib.

III. The domestic clinical trial has started, and patients can apply for the drug for free

On May 10, 2021, the clinical trial study of Ribotinib in China At the start, a total of 31 test centers in the mainland participated in the research. The subjects recruited for the trial were patients with solid tumors of non-small cell lung cancer carrying ROS1 and NTRK1/2/3 rearrangements. As of now, the recruitment is still in progress. As long as the patients meet the criteria and are successfully selected, not only the drug examination is completely free, but also a professional medical team will follow up and guide the drug use during the treatment process.

It is worth noting that the probability of NTRK and ROS1 fusion is small, and there are not many patients who may meet the conditions.

NTRK fusion mutations account for less than 1% in most solid tumor types, only 3.5% of lung cancer patients have NTRK fusions, and ROS1 fusions only 1%. strong>1%, the proportion of NTRK fusion in colorectal cancer is lower than 1.5%. The highest solid tumors in NTRK fusion are congenital fibrosarcoma and congenital mesodermal renal carcinoma, accounting for more than 90%, but these cancers themselves are not clinically recognized. rare.

On the whole, only a few people can really benefit from Ribotinib. This makes it difficult for many cancer patients to accept. There is such a good magic medicine but not people use it? What is the reason for this?

Fourth, the effect of targeted drugs is remarkable, why not everyone can use it?

1. Targeted drugs can only be used if they have a target.

Rebotinib is a type of targeted drug, no matter what it is Targeted drugs, in order to play their role, need a major premise that the patient has a target in the body. Each targeted drug can only target one or a few targets, which are actually mutated genes in tumor cells. There are no corresponding drugs for the mutated genes in many tumor patients, that is, there is no target, and targeted drugs cannot be used for treatment..

2. Some people become resistant after eating, and eventually there is no medicine to cure

Cancer cells are very “cunning”, they will constantly change themselves with medication, and their mutation types may change after a period of treatment. At this time, the original drug treatment will have a very unsatisfactory effect, because cancer cells Cells have developed resistance to such drugs. If you want to inhibit the development of cancer cells, you can only “find another way” and choose other drugs.

3. No need to take it in the early stage of cancer

Most early stage lung cancer patients can achieve clinical cure through surgery, and these patients do not need to use targeted therapy drug. If targeted drugs are used blindly, patients will easily fall into the predicament of no cure when the disease recurs.

The emergence of new drugs will undoubtedly bring new hope to many cancer patients, but we still need to have a correct attitude and not blindly follow.

References:

[1] “Targeted drugs are not suitable for all lung cancer patients, and they should be disabled in the early stage of lung cancer! ”. Health News. 2015.11.12

[2] “Can the Newly Marketed Miracle Drug in the U.S. Treat 17 Types of Cancer? Don’t get excited too early”. Southern Metropolis Weekly. 2018.11.29