优先选取靶向药还是免疫药？一文读懂靶向治疗 VS 免疫治疗的区别
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">1、<span style="color: black;">功效</span>机制<span style="color: black;">区别</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">靶向治疗——<span style="color: black;">精细</span>打击的生物导弹</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">靶向<span style="color: black;">药品</span>，顾名思义，针对的是癌细胞上特定的靶点，<span style="color: black;">例如</span>某个特有的基因突变。靶向<span style="color: black;">药品</span>和化疗的目的都是直接杀死尽可能多的癌细胞。比起化疗，靶向<span style="color: black;">药品</span>理论上只会<span style="color: black;">控制</span>癌细胞，而不会对正常细胞<span style="color: black;">导致</span><span style="color: black;">明显</span><span style="color: black;">损伤</span>，<span style="color: black;">因此呢</span>副<span style="color: black;">功效</span>小<span style="color: black;">非常多</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q2.itc.cn/images01/20240520/67e79ee1e0db4542a15bc4c6245db652.jpeg" style="width: 50%; margin-bottom: 20px;"><span style="color: black;">图1：乳腺癌靶向治疗途径</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">免疫治疗——依靠<span style="color: black;">自己</span>的免疫系统</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">免疫治疗与以往抗肿瘤<span style="color: black;">药品</span>的<span style="color: black;">功效</span>机理完全<span style="color: black;">区别</span>。免疫治疗针对的靶标不是肿瘤细胞，而是人体<span style="color: black;">自己</span>的免疫细胞。免疫药<span style="color: black;">经过</span>激活<span style="color: black;">自己</span>免疫系统，恢复机体正常的抗肿瘤免疫反应，依靠<span style="color: black;">自己</span>免疫机能杀灭肿瘤细胞。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q8.itc.cn/images01/20240520/af252b9502564a948b0e2ee4d4461e32.jpeg" style="width: 50%; margin-bottom: 20px;"><span style="color: black;">图2：癌症-免疫循环</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">2、副<span style="color: black;">功效</span><span style="color: black;">区别</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">靶向<span style="color: black;">药品</span><span style="color: black;">常常</span>针对的是对肿瘤生长<span style="color: black;">导致</span>影响的<span style="color: black;">要紧</span>蛋白，<span style="color: black;">因此呢</span>在其杀伤癌细胞的<span style="color: black;">同期</span><span style="color: black;">亦</span>有可能“伤及<span style="color: black;">没</span>辜”，如肺癌EGFR靶向<span style="color: black;">药品</span>吉非替尼，对表皮细胞有副<span style="color: black;">功效</span>，<span style="color: black;">因此</span><span style="color: black;">病人</span><span style="color: black;">运用</span>后会有<span style="color: black;">显著</span>的皮疹。而在免疫<span style="color: black;">药品</span><span style="color: black;">运用</span>过程中，常常<span style="color: black;">由于</span>免疫系统过度活化而<span style="color: black;">导致</span>副<span style="color: black;">功效</span>，<span style="color: black;">包含</span><span style="color: black;">因为</span>免疫激活而<span style="color: black;">引起</span>的皮疹、肠炎、腹泻和肝<span style="color: black;">损害</span>等。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q7.itc.cn/images01/20240520/3178f09825f541b7bdd5d60e328e8a74.jpeg" style="width: 50%; margin-bottom: 20px;"><span style="color: black;">图3：靶向治疗与免疫治疗<span style="color: black;">平常</span>副<span style="color: black;">功效</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">3、<span style="color: black;">生效</span>速度</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">靶向治疗——<span style="color: black;">生效</span>快</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">靶向治疗是直接<span style="color: black;">功效</span>于肿瘤细胞上的特定靶点，<span style="color: black;">因此呢</span><span style="color: black;">常常</span><span style="color: black;">生效</span>较快。<span style="color: black;">倘若</span>有效，<span style="color: black;">一般</span>在几周内，<span style="color: black;">乃至</span>几天内<span style="color: black;">能够</span>看到肿瘤体积缩小，<span style="color: black;">或</span>肿瘤标记物减少，但<span style="color: black;">区别</span>靶向药的<span style="color: black;">生效</span>时间存在差异。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">免疫治疗——<span style="color: black;">生效</span>慢</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">相较而言，免疫治疗<span style="color: black;">经过</span>激活免疫系统，间接杀死肿瘤细胞，<span style="color: black;">因此呢</span><span style="color: black;">生效</span>时间要慢得多<span style="color: black;">亦</span>更<span style="color: black;">繁杂</span>，<span style="color: black;">非常多</span><span style="color: black;">病人</span>在接受治疗3个月以后才<span style="color: black;">起始</span>见效。因此，<span style="color: black;">意见</span><span style="color: black;">病人</span>每8-10周复查一次肿瘤部位的CT或MRI，判断治疗效果；刚<span style="color: black;">起始</span>治疗时可能<span style="color: black;">显现</span>肿瘤的增大或<span style="color: black;">显现</span>新的病灶，<span style="color: black;">必须</span>在治疗4-6周时<span style="color: black;">评定</span>病情是“假性<span style="color: black;">发展</span>”还是“超<span style="color: black;">发展</span>”。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q1.itc.cn/images01/20240520/4959be26f7a74765a8318f517aada509.jpeg" style="width: 50%; margin-bottom: 20px;"><span style="color: black;">图4：超<span style="color: black;">发展</span>与假性<span style="color: black;">发展</span>的定义</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">4、<span style="color: black;">长时间</span>、短期效果</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">靶向<span style="color: black;">药品</span>效率高，<span style="color: black;">况且</span><span style="color: black;">生效</span>快，能<span style="color: black;">快速</span>缓解肿瘤带来的症状，<span style="color: black;">加强</span><span style="color: black;">病人</span>的生活质量，一<span style="color: black;">按时</span>期内能<span style="color: black;">明显</span><span style="color: black;">加强</span>存活率。但靶向<span style="color: black;">药品</span>又有一个通病，<span style="color: black;">常常</span>一<span style="color: black;">按时</span>间后便会<span style="color: black;">显现</span>耐药，<span style="color: black;">此时</span>就<span style="color: black;">必须</span>重新换药，靶向治疗极少<span style="color: black;">显现</span>单药<span style="color: black;">长时间</span>存活或治愈。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">而<span style="color: black;">日前</span>免疫治疗最大的问题是有效率不高，<span style="color: black;">仅有</span>10%-20%(部分肿瘤类型除外)，但与靶向<span style="color: black;">药品</span>相比，免疫治疗虽然<span style="color: black;">生效</span>较慢，一旦<span style="color: black;">生效</span>，<span style="color: black;">病人</span><span style="color: black;">常常</span>会<span style="color: black;">长时间</span>受益，<span style="color: black;">乃至</span>有一小部分<span style="color: black;">病人</span>会长期存活，<span style="color: black;">乃至</span>被治愈。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">5、<span style="color: black;">精细</span>程度<span style="color: black;">区别</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">经过深入<span style="color: black;">科研</span>，靶向<span style="color: black;">药品</span>的<span style="color: black;">运用</span>原理越来越清晰，<span style="color: black;">一般</span>是携带特定基因突变的肿瘤。许多靶向<span style="color: black;">药品</span>的<span style="color: black;">运用</span>被认为是“精确的”。而<span style="color: black;">针对</span>免疫<span style="color: black;">药品</span><span style="color: black;">来讲</span>，预测疗效是困难的，<span style="color: black;">引起</span><span style="color: black;">运用</span>指征“不<span style="color: black;">精细</span>”，对<span style="color: black;">海量</span>人群进行盲法<span style="color: black;">实验</span>，<span style="color: black;">一般</span><span style="color: black;">仅有</span>10%的成功率。但免疫疗法的疗效预测<span style="color: black;">日前</span>在<span style="color: black;">已然</span>取得<span style="color: black;">有些</span>突破，编者相信免疫疗法<span style="color: black;">最后</span>将进入“<span style="color: black;">精细</span>化”道路。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">总之，靶向<span style="color: black;">药品</span>和免疫<span style="color: black;">药品</span>存在很大区别，靶向治疗和免疫治疗<span style="color: black;">怎样</span><span style="color: black;">选取</span>？其实<span style="color: black;">无</span>标准答案，<span style="color: black;">重要</span>是<span style="color: black;">看清</span>每类<span style="color: black;">药品</span>的特点，<span style="color: black;">按照</span><span style="color: black;">自己</span>的<span style="color: black;">状况</span>来正确<span style="color: black;">选取</span>合适的<span style="color: black;">药品</span>，获益<span style="color: black;">才可</span>最大。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">内容<span style="color: black;">源自</span>：公众号 桐树生物</p>
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感谢你的精彩评论，带给我新的思考角度。 楼主发的这篇帖子，我觉得非常有道理。 你的见解真是独到，让我受益匪浅。 你的见解独到，让我受益匪浅，非常感谢。
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