抗肿瘤药阿扎胞苷(3)
5 结语
MDS长期以来没有有效的治疗药物，直到美国FDA先后批准阿扎胞苷和地西他滨，其中阿扎胞苷是目前唯一一个已被临床证明可延长高风险MDS患者OS的药物。在AZA-001研究中，与CCR相比，使用阿扎胞苷治疗能够延长中位OS 9.4个月、2年生存率几乎翻番。因此，阿扎胞苷在国内的早日上市和临床应用值得期待。
参考文献
[1] Piskala A， Sorm F. Nucleic acid components and their analogues. LI. Synthesis of 1-glycosyl derivatives of 5-azauracil and 5-azacytosine [J]. Collect Czech Chem Commun， 1964， 29(9)： 2060-2076.
[2] Hanka LJ， Evans JS， Masom DJ， et al. Microbial production of 5-azacytidine. I. Production and biological activity [J]. Antimicrob Agents Chemother， 1966， 6： 619-624.
, 百拇医药
[3] Celgene Corporation. Vidaza prescribing information [EB/OL]. [2012-04-09]. http：//www.vidaza.com/pdf/PI_FINAL.pdf.
[4] European Medicines Agency. European Public Assessment Report， VIDAZA [EB/OL]. [2012-04-09]. http：//www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Summary_for_the_public/human/000978/WC500050240.pdf.
[5] 日本新药株式会社. ビダーザ注射用100 mg添付文书[EB/OL]. [2012-04-20]. http：//www.nippon-shinyaku.co.jp/official/medicine/product/doc_vidaza.pdf.
, 百拇医药
[6] Siddiqui MAA， Scott LJ. Azacitidine： in myelodysplastic syndromes [J]. Drugs， 2005， 65(13)： 1781-1789.
[7] Stresemann C， Lyko F. Modes of action of the DNA methyltransferase inhibitors azacytidine and decitabine [J]. Int J Cancer， 2008， 123(1)： 8-13.
[8] Marcucci G， Silverman L， Eller M， et al. Bioavailability of azacitidine subcutaneous versus intravenous in patients with the myelodysplastic syndromes [J]. J Clin Pharmacol， 2005， 45(5)： 597-602.
, 百拇医药
[9] Uchida T， Ogawa Y， Kobayashi Y， et al. Phase I and II study of azacitidine in Japanese patients with myelodysplastic syndromes [J]. Cancer Sci， 2011， 102(9)： 1680-1686.
[10] Platzbecker U， Wermke M， Radke J， et al. Azacitidine for treatment of imminent relapse in MDS or AML patients after allogeneic HSCT： results of the RELAZA trial [J]. Leukemia， 2012， 26(3)： 381-389.
[11] Fenaux P， Mufti GJ， Hellstrom-Lindberg E， et al. Efficacy of azacitidine compared with that of conventional care regimens in the treatment of higher-risk myelodysplastic syndromes： a randomised， open-label， phase III study [J]. Lancet Oncol， 2009， 10(3)： 223-232.
, 百拇医药
[12] Seymour JF， Fenaux P， Silverman LR， et al. Effects of azacitidine compared with conventional care regimens in elderly (≥75 years) patients with higher-risk myelodysplastic syndromes [J]. Crit Rev Oncol Hematol， 2010， 76(3)： 218-227.
[13] Fenaux P， Mufti GJ， Hellstr?m-Lindberg E， et al. Azacitidine prolongs overall survival compared with conventional care regimens in elderly patients with low bone marrow blast count acute myeloid leukemia [J]. J Clin Oncol， 2010， 28(4)： 562-569.
, http://www.100md.com
[14] Garcia-Manero G， Gore SD， Cogle C， et al. Phase I study of oral azacitidine in myelodysplastic syndromes， chronic myelomonocytic leukemia， and acute myeloid leukemia [J]. J Clin Oncol， 2011， 29(18)： 2521-2527.
[15] Scrip Intelligence. Dacogen fails phase III survival trial in MDS [EB/OL]. [2012-04-02]. http：//www.scripintelligence.com/researchdevelopment/Dacogen-fails-Phase-III-survival-trial-in-MDS-1384.
[16] Gidwani R， Khan ZM， Fenaux P， et al. A cost-effectiveness analysis of using azacitidine vs. decitabine in treating patients with myelodysplastic syndromes [J]. J Med Econ， 2012， 15(1)： 145-154.
(收稿日期：2012-05-08), http://www.100md.com(张庆文)
MDS长期以来没有有效的治疗药物，直到美国FDA先后批准阿扎胞苷和地西他滨，其中阿扎胞苷是目前唯一一个已被临床证明可延长高风险MDS患者OS的药物。在AZA-001研究中，与CCR相比，使用阿扎胞苷治疗能够延长中位OS 9.4个月、2年生存率几乎翻番。因此，阿扎胞苷在国内的早日上市和临床应用值得期待。
参考文献
[1] Piskala A， Sorm F. Nucleic acid components and their analogues. LI. Synthesis of 1-glycosyl derivatives of 5-azauracil and 5-azacytosine [J]. Collect Czech Chem Commun， 1964， 29(9)： 2060-2076.
[2] Hanka LJ， Evans JS， Masom DJ， et al. Microbial production of 5-azacytidine. I. Production and biological activity [J]. Antimicrob Agents Chemother， 1966， 6： 619-624.
, 百拇医药
[3] Celgene Corporation. Vidaza prescribing information [EB/OL]. [2012-04-09]. http：//www.vidaza.com/pdf/PI_FINAL.pdf.
[4] European Medicines Agency. European Public Assessment Report， VIDAZA [EB/OL]. [2012-04-09]. http：//www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Summary_for_the_public/human/000978/WC500050240.pdf.
[5] 日本新药株式会社. ビダーザ注射用100 mg添付文书[EB/OL]. [2012-04-20]. http：//www.nippon-shinyaku.co.jp/official/medicine/product/doc_vidaza.pdf.
, 百拇医药
[6] Siddiqui MAA， Scott LJ. Azacitidine： in myelodysplastic syndromes [J]. Drugs， 2005， 65(13)： 1781-1789.
[7] Stresemann C， Lyko F. Modes of action of the DNA methyltransferase inhibitors azacytidine and decitabine [J]. Int J Cancer， 2008， 123(1)： 8-13.
[8] Marcucci G， Silverman L， Eller M， et al. Bioavailability of azacitidine subcutaneous versus intravenous in patients with the myelodysplastic syndromes [J]. J Clin Pharmacol， 2005， 45(5)： 597-602.
, 百拇医药
[9] Uchida T， Ogawa Y， Kobayashi Y， et al. Phase I and II study of azacitidine in Japanese patients with myelodysplastic syndromes [J]. Cancer Sci， 2011， 102(9)： 1680-1686.
[10] Platzbecker U， Wermke M， Radke J， et al. Azacitidine for treatment of imminent relapse in MDS or AML patients after allogeneic HSCT： results of the RELAZA trial [J]. Leukemia， 2012， 26(3)： 381-389.
[11] Fenaux P， Mufti GJ， Hellstrom-Lindberg E， et al. Efficacy of azacitidine compared with that of conventional care regimens in the treatment of higher-risk myelodysplastic syndromes： a randomised， open-label， phase III study [J]. Lancet Oncol， 2009， 10(3)： 223-232.
, 百拇医药
[12] Seymour JF， Fenaux P， Silverman LR， et al. Effects of azacitidine compared with conventional care regimens in elderly (≥75 years) patients with higher-risk myelodysplastic syndromes [J]. Crit Rev Oncol Hematol， 2010， 76(3)： 218-227.
[13] Fenaux P， Mufti GJ， Hellstr?m-Lindberg E， et al. Azacitidine prolongs overall survival compared with conventional care regimens in elderly patients with low bone marrow blast count acute myeloid leukemia [J]. J Clin Oncol， 2010， 28(4)： 562-569.
, http://www.100md.com
[14] Garcia-Manero G， Gore SD， Cogle C， et al. Phase I study of oral azacitidine in myelodysplastic syndromes， chronic myelomonocytic leukemia， and acute myeloid leukemia [J]. J Clin Oncol， 2011， 29(18)： 2521-2527.
[15] Scrip Intelligence. Dacogen fails phase III survival trial in MDS [EB/OL]. [2012-04-02]. http：//www.scripintelligence.com/researchdevelopment/Dacogen-fails-Phase-III-survival-trial-in-MDS-1384.
[16] Gidwani R， Khan ZM， Fenaux P， et al. A cost-effectiveness analysis of using azacitidine vs. decitabine in treating patients with myelodysplastic syndromes [J]. J Med Econ， 2012， 15(1)： 145-154.
(收稿日期：2012-05-08), http://www.100md.com(张庆文)