Tumori, tra recidive e metastasi ecco i farmaci che aiutano a vivere

Pubblicato il 12 Febbraio 2013 da AndosVelletri

La ricerca ha prodotto 9 nuovi medicinali che saranno in commercio anche in Italia entro il 2013, e altri 4 attesi nel 2014 a conclusione della sperimentazione.Non riescono a “spegnere” la proliferazione incontrollata delle cellule cancerose, ma permettono sopravvivenze anche di anni

BOSTON – Sono nove i farmaci nuovi contro vari tipi di cancro la cui autorizzazione in Italia è prevista per quest’anno, in genere già autorizzati negli Usa e in Europa. Altri quattro il prossimo anno, se le autorità regolatorie europee e poi italiane avranno completato l’esame della enorme mole di dati dei risultati. Nessuno guarisce dal cancro, come il mix di farmaci che eradica la leucemia promielocitica acuta, al momento unica cura farmacologica definitiva, messa a punto da Pier Paolo Pandolfi direttore del Beth Israel, uno dei quattro centri di ricerca oncologica della Harvard University di Boston.

I farmaci in arrivo contrastano la proliferazione incontrollata del cancro, ma non lo spengono. Per questo si useranno quando il tumore è scoperto troppo tardi per essere asportato e ha già dato metastasi. Regalano sopravvivenze di qualche anno contro i pochi mesi dei trattamenti attuali. Di fatto, un miracolo, anche se molto costoso perché i farmaci di questo tipo, cosiddetti “intelligenti”, già in commercio arrivano a costare anche 60 mila euro per mese di trattamento.

I tredici farmaci in arrivo (per 15 tipi di tumori perché alcuni hanno più indicazioni) hanno tutti mosso i primi passi circa una decina di anni fa grazie a collaborazioni tra cliniche e centri di ricerca universitari e industrie farmaceutiche, come quella realizzata qui tra la Novartis e il Dana Farber, un altro dei quattro istituti oncologici di Harvard. In genere si è partiti dalla scoperta di un gene la cui alterazione innesca la moltiplicazione incontrollata delle cellule.

Poi si è messa a punto una molecola che riesce ad inceppare il meccanismo patologico avviato dal gene anomalo. E infine la si è provata su colture di cellule animali, umane, topi e pazienti, se le sperimentazioni precedenti erano state superate, per verificare che desse benefici e che questi fossero superiori agli effetti collaterali. Un lungo percorso che ha lasciato per strada centinaia di molecole perché hanno fallito anche una sola delle varie prove.

Ed ecco i farmaci in arrivo messi a punto dalla maggiori aziende farmaceutiche. Da Novartis è appena arrivato (dicembre 2012) l’everolimus col nome commerciale Afinitor, per il trattamento dei tumori neuroendocrini di origine pancreatica in fase avanzata. Contrasta l’attivazione aberrante del gene mTOR, alla base dello sviluppo del tumore. È il primo nuovo farmaco per questi tumori scoperto negli ultimi 30 anni.

Lo stesso Afinitor, sta per essere immesso anche in Italia per il trattamento con exemestane, delle donne in post-menopausa con stato recettoriale ormonale positivo affette da carcinoma mammario tipo HER2/neu negativo, dopo recidive o progressione di malattia e dopo il fallimento della terapia ormonale con inibitori dell’aromatasi non steroidei.
Signifor (nome della molecola pasireotide) invece è destinato a contrastare i tumori dell’ipofisi, dopo fallimento della chirurgia, che portano la Sindrome di Cushing, grave squilibrio ormonale potenzialmente letale e l’acromegalia, una deformazione progressiva di volto e mani. Jakavi (ruxolitinib) per il trattamento della mielofibrosi, neoplasia rara che colpisce il midollo osseo.

Termineranno invece quest’anno la sperimentazione: dovitinib (non ha ancora il nome commerciale) contro il tumore al rene in fase metastatica, Afinitor contro il tumore al seno metastatico tipo Her2+ e Her2-, Jakavi per la policitemia, panobinostat contro il mieloma multiplo.
Da Pfizer sono in arrivo: Inlyta (axitinib) contro il carcinoma renale inoperabile in adulti, dopo fallimento di un precedente trattamento con sunitinib o con una citochina; Xalcori (crizotinib) contro il carcinoma polmonare del tipo non a piccole cellule e positivo al test ALK; Bosulif (bosutinib) contro la leucemia mieloide cronica.

Da Lilly arriva Pemetrexed (nome commerciale Alimta), da usare anche come cura di mantenimento, e non solo iniziale, contro il tumore del polmone del tipo “non a piccole cellule non squamoso”. Ha superato la fase sperimentale e dovrebbe arrivare il prossimo anno ramucirumab (non ha ancora un nome commerciale) da somministrare contro il carcinoma gastrico metastatico.
Da Bristol Meyer Squibb arriva Ipilimumab (nome commerciale) Yervoy contro il melanoma non operabile o metastatico già trattato. Non ha ancora il nome commerciale elotuzumab che sta dando ottimi risultati contro il melanoma nella sperimentazione.

Da Sanofi è in arrivo aflibercept (Zaltrap) contro il tumore metastatico del colon-retto, da dare con chemioterapia (irinotecano/5-fluorouracile/ acido folinico) e che non risponde più alle cure standard. Infine afatinib di Boehringer-Ingelheim ha terminato la sperimentazione per il trattamento del tumore del polmone non a piccole cellule che da agosto è stata inviata all’ente regolatorio europeo.

Fonte: “Repubblica.it” – 15 gennaio 2013

Questa voce è stata pubblicata in News e contrassegnata con , . Contrassegna il permalink.

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