查看“依尼帕利”的源代码

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            <strong>[[依尼帕利]]</strong>（<strong>[[Iniparib]]</strong>）是一种曾被错误归类为<strong>[[PARP抑制剂]]</strong>的小分子药物，由[[Sanofi-Aventis]]研发。它曾被寄予厚望用于治疗<strong>[[三阴性乳腺癌]]</strong>（[[TNBC]]）及[[鳞状非小细胞肺癌]]。然而，随着临床试验的深入，[[依尼帕利]]在关键的III期临床研究中均告失败。后期分子机制研究证实，其并不具备显著的[[PARP1]]抑制活性，而是通过共价修饰多种蛋白质（如[[半胱氨酸]]残基）产生非特异性细胞毒性。[[依尼帕利]]的研发历程已成为现代精准医学中“靶点验证”重要性的经典反面教材，促使医药界对[[PARP]]抑制剂的选择性定义进行了重新审视。
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            <div style="font-size: 1.2em; font-weight: bold; letter-spacing: 1.2px;">[[依尼帕利]]</div>
            <div style="font-size: 0.75em; opacity: 0.85; margin-top: 4px;">[[Iniparib]] / [[BSI-201]] · 点击展开</div>
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                    <div style="width: 140px; height: 90px; background-color: #f1f5f9; display: flex; align-items: center; justify-content: center; color: #94a3b8; font-size: 0.8em; padding: 10px; text-align: center;">[[Iniparib]]化学结构模型</div>
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                <div style="font-size: 0.8em; color: #64748b; margin-top: 12px; font-weight: 600;">曾用名：[[PARP]]抑制剂候选项</div>
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                    <th style="text-align: left; padding: 8px 12px; background-color: #f1f5f9; color: #475569; border-bottom: 1px solid #e2e8f0; width: 45%;">拟定靶点</th>
                    <td style="padding: 8px 12px; border-bottom: 1px solid #e2e8f0; color: #0f172a;">[[PARP1]] (142)</td>
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                    <th style="text-align: left; padding: 8px 12px; background-color: #f1f5f9; color: #475569; border-bottom: 1px solid #e2e8f0;">药物类型</th>
                    <td style="padding: 8px 12px; border-bottom: 1px solid #e2e8f0; color: #1e40af;">[[共价修饰剂]]</td>
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                    <th style="text-align: left; padding: 8px 12px; background-color: #f1f5f9; color: #475569; border-bottom: 1px solid #e2e8f0;">[[CAS]]号</th>
                    <td style="padding: 8px 12px; border-bottom: 1px solid #e2e8f0; color: #0f172a;">160003-08-1</td>
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                    <th style="text-align: left; padding: 8px 12px; background-color: #f1f5f9; color: #475569; border-bottom: 1px solid #e2e8f0;">分子式</th>
                    <td style="padding: 8px 12px; border-bottom: 1px solid #e2e8f0; color: #0f172a;">$C_7H_4INO_3$</td>
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                    <th style="text-align: left; padding: 8px 12px; background-color: #f1f5f9; color: #475569; border-bottom: 1px solid #e2e8f0;">分子量</th>
                    <td style="padding: 8px 12px; border-bottom: 1px solid #e2e8f0; color: #0f172a;">293.01 Da</td>
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                    <th style="text-align: left; padding: 8px 12px; background-color: #f1f5f9; color: #475569;">当前状态</th>
                    <td style="padding: 12px; color: #e11d48; font-weight: bold;">研发终止</td>
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    <h2 style="background: #f1f5f9; color: #0f172a; padding: 10px 18px; border-radius: 0 6px 6px 0; font-size: 1.25em; margin-top: 40px; border-left: 6px solid #0f172a; font-weight: bold;">机制解析：从PARP抑制到非特异性修饰</h2>
    
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        [[依尼帕利]]在研发早期被认为能够抑制[[PARP1]]，通过阻断[[DNA]]单链损伤修复引发“[[合成致死]]”。然而，后续的药理学研究揭示了其真实的作用逻辑：
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        <li style="margin-bottom: 12px;"><strong>缺乏PARP亲和力：</strong>生化研究表明，[[依尼帕利]]在生理浓度下对[[PARP1]]、[[PARP2]]的抑制作用极弱，远低于[[奥拉帕利]]等真正的[[PARP]]抑制剂。</li>
        <li style="margin-bottom: 12px;"><strong>共价修饰蛋白质：</strong>[[依尼帕利]]（[[4-碘-3-硝基苯甲酰胺]]）是一种活性化学分子，它能通过共价结合的方式修饰细胞内蛋白质表面的[[半胱氨酸]]残基，导致蛋白质功能失活。</li>
        <li style="margin-bottom: 12px;"><strong>氧化应激诱导：</strong>该药物在胞内可能诱发活性氧（[[ROS]]）的产生，从而导致DNA损伤，这种作用是广泛的而非靶点驱动的。</li>
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    <h2 style="background: #f1f5f9; color: #0f172a; padding: 10px 18px; border-radius: 0 6px 6px 0; font-size: 1.25em; margin-top: 40px; border-left: 6px solid #0f172a; font-weight: bold;">临床研究轨迹：从突破性预期到III期溃败</h2>

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                <th style="padding: 10px; border: 1px solid #cbd5e1; color: #0f172a; width: 25%;">研究阶段</th>
                <th style="padding: 10px; border: 1px solid #cbd5e1; color: #475569;">目标患者人群</th>
                <th style="padding: 10px; border: 1px solid #cbd5e1; color: #1e40af;">临床结果表型</th>
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                <td style="padding: 8px; border: 1px solid #cbd5e1; font-weight: 600;">[[II期临床]]</td>
                <td style="padding: 8px; border: 1px solid #cbd5e1;">转移性[[三阴性乳腺癌]]</td>
                <td style="padding: 8px; border: 1px solid #cbd5e1;">表现出令人惊喜的 [[PFS]] 与 [[OS]] 获益，引起学术界轰动。</td>
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                <td style="padding: 8px; border: 1px solid #cbd5e1; font-weight: 600;">[[III期临床]]</td>
                <td style="padding: 8px; border: 1px solid #cbd5e1;">转移性[[三阴性乳腺癌]]</td>
                <td style="padding: 8px; border: 1px solid #cbd5e1;"><strong>未达到</strong> [[PFS]] 和 [[OS]] 主要终点。</td>
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                <td style="padding: 8px; border: 1px solid #cbd5e1; font-weight: 600;">[[肺癌研究]]</td>
                <td style="padding: 8px; border: 1px solid #cbd5e1;">晚期[[鳞状NSCLC]]</td>
                <td style="padding: 8px; border: 1px solid #cbd5e1;">III期研究由于未显示生存优势而终止。</td>
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    <h2 style="background: #f1f5f9; color: #0f172a; padding: 10px 18px; border-radius: 0 6px 6px 0; font-size: 1.25em; margin-top: 40px; border-left: 6px solid #0f172a; font-weight: bold;">研发反思：靶点验证的临床教训</h2>
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        [[依尼帕利]]的失败为2026年的制药工业留下了深远的遗产：
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        <li style="margin-bottom: 12px;"><strong>靶点确认的严谨性：</strong>早期将其错误定义为[[PARP抑制剂]]误导了后续的患者筛选（如未聚焦 [[BRCA突变]]）。</li>
        <li style="margin-bottom: 12px;"><strong>II期与III期的鸿沟：</strong>小样本II期试验的“假阳性”信号在缺乏严谨靶点支持时，难以在III期大样本中重现。</li>
        <li style="margin-bottom: 12px;"><strong>精准医疗的进化：</strong>依尼帕利的失败直接催生了[[PARP捕获效应]]（[[PARP-trapping]]）等评价标准的确立，后续药物如[[尼拉帕利]]等因此受益。</li>
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            <li style="margin-bottom: 8px;"><strong>[[PARP1]]：</strong>真正的 [[PARP]] 抑制剂的核心靶点，参与单链断裂修复。</li>
            <li style="margin-bottom: 8px;"><strong>[[合成致死]]：</strong>[[PARP抑制剂]]治疗 [[BRCA]] 突变患者的底层逻辑。</li>
            <li style="margin-bottom: 8px;"><strong>[[奥拉帕利]] (Olaparib)：</strong>全球首个获批的真实 [[PARP]] 抑制剂。</li>
            <li style="margin-bottom: 8px;"><strong>[[三阴性乳腺癌]] (TNBC)：</strong>[[依尼帕利]]最主要的失败阵地。</li>
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        <span style="color: #0f172a; font-weight: bold; font-size: 1.05em; display: inline-block; margin-bottom: 15px;">学术参考文献与权威点评</span>
        
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            [1] <strong>O'Shaughnessy J, et al. (2011).</strong> <em>Iniparib plus chemotherapy in metastatic triple-negative breast cancer.</em> <strong>[[The New England Journal of Medicine]]</strong>. 364:205-214.[Academic Review]<br>
            <span style="color: #475569;">[权威点评]：该项早期的II期研究结果曾让依尼帕利被视为乳腺癌治疗的“游戏改变者”。</span>
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            [2] <strong>O'Shaughnessy J, et al. (2014).</strong> <em>Phase III study of iniparib plus gemcitabine and carboplatin in patients with metastatic triple-negative breast cancer.</em> <strong>[[Journal of Clinical Oncology]]</strong>. 32(34):3840-7.<br>
            <span style="color: #475569;">[核心价值]：正式宣告了依尼帕利在TNBC领域的研发失败，引发了对其真实机制的深层反思。</span>
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            [[依尼帕利]] ([[Iniparib]]) 研发历史 · 知识图谱
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                <td style="width: 85px; background-color: #f8fafc; color: #334155; font-weight: 600; padding: 10px 12px; text-align: right; vertical-align: middle; white-space: nowrap;">关联靶点</td>
                <td style="padding: 10px 15px; color: #334155;">[[PARP1]](拟定)•[[PARP2]](拟定)•[[Cysteine residues]](真实)</td>
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                <td style="width: 85px; background-color: #f8fafc; color: #334155; font-weight: 600; padding: 10px 12px; text-align: right; vertical-align: middle; white-space: nowrap;">真实PARP抑制剂</td>
                <td style="padding: 10px 15px; color: #334155;">[[奥拉帕利]]•[[尼拉帕利]]•[[卢卡帕利]]•[[帕佐帕利]]</td>
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                <td style="width: 85px; background-color: #f8fafc; color: #334155; font-weight: 600; padding: 10px 12px; text-align: right; vertical-align: middle; white-space: nowrap;">战略实体</td>
                <td style="padding: 10px 15px; color: #334155;">[[Sanofi]]•[[FDA]]•[[BiPar Sciences]]</td>
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                <td style="width: 85px; background-color: #f8fafc; color: #334155; font-weight: 600; padding: 10px 12px; text-align: right; vertical-align: middle; white-space: nowrap;">领域警示</td>
                <td style="padding: 10px 15px; color: #334155;">[[靶点脱靶风险]]•[[II期结果外推局限性]]•[[化学结构活性分类错误]]</td>
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