查看“Enzastaurin”的源代码

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            <strong>[[恩扎妥林]]</strong>（<strong>[[Enzastaurin]]</strong>）是一种口服的、具有高度选择性的<strong>[[丝氨酸/苏氨酸激酶抑制剂]]</strong>，主要靶向<strong>[[蛋白激酶Cβ]]</strong>（<strong>[[PKCβ]]</strong>）及<strong>[[PI3K/AKT]]</strong>信号通路。该药物由[[礼来]]（[[Eli Lilly]]）最初研发，目前由<strong>[[鼎康生物]]</strong>（[[Denovo Biopharma]]）主导其全球开发。[[恩扎妥林]]通过阻断肿瘤细胞的[[血管生成]]、诱导[[细胞凋亡]]并抑制肿瘤细胞[[增殖]]发挥抗肿瘤作用。截至2026年，[[恩扎妥林]]在治疗<strong>[[弥漫性大B细胞淋巴瘤]]</strong>（[[DLBCL]]）及<strong>[[多形性胶质母细胞瘤]]</strong>（[[GBM]]）等[[恶性肿瘤]]中展现了显著的个体化医疗价值，特别是针对携带特定[[生物标志物]]（如<strong>[[DGM1]]</strong>）的精准人群。
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            <div style="font-size: 1.2em; font-weight: bold; letter-spacing: 1.2px;">[[恩扎妥林]]</div>
            <div style="font-size: 0.7em; opacity: 0.85; margin-top: 4px;">[[Enzastaurin]] / [[DB102]] · 点击展开</div>
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                <div style="font-size: 0.8em; color: #64748b; margin-top: 12px; font-weight: 600;">核心靶标：[[PKCβ]] / [[AKT]]</div>
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                    <td style="padding: 6px 12px; border-bottom: 1px solid #e2e8f0; color: #0f172a;">5579([[PRKCB]])</td>
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                    <td style="padding: 6px 12px; border-bottom: 1px solid #e2e8f0; color: #0f172a;">9402</td>
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                    <th style="text-align: left; padding: 6px 12px; background-color: #f1f5f9; color: #475569; border-bottom: 1px solid #e2e8f0;">[[CAS]]登记号</th>
                    <td style="padding: 6px 12px; border-bottom: 1px solid #e2e8f0; color: #0f172a;">170364-57-5</td>
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                    <th style="text-align: left; padding: 6px 12px; background-color: #f1f5f9; color: #475569; border-bottom: 1px solid #e2e8f0;">药物分类</th>
                    <td style="padding: 6px 12px; border-bottom: 1px solid #e2e8f0; color: #1e40af;">[[双通道激酶抑制剂]]</td>
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                    <th style="text-align: left; padding: 6px 12px; background-color: #f1f5f9; color: #475569; border-bottom: 1px solid #e2e8f0;">关键标志物</th>
                    <td style="padding: 6px 12px; border-bottom: 1px solid #e2e8f0; color: #b91c1c;">[[DGM1]] ([[基因组标志物]])</td>
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                    <th style="text-align: left; padding: 6px 12px; background-color: #f1f5f9; color: #475569;">开发实体</th>
                    <td style="padding: 12px; color: #0f172a;">[[鼎康生物]] / [[礼来]]</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;">分子机制：阻断肿瘤生存的双重路径</h2>
    
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        [[恩扎妥林]]的作用机理体现了对肿瘤信号网络的精确拦截：
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        <li style="margin-bottom: 12px;"><strong>抑制[[PKCβ]]激活：</strong>[[恩扎妥林]]竞争性地结合[[PKCβ]]的[[ATP结合口袋]]。在[[淋巴瘤]]中，[[PKCβ]]是[[B细胞受体]]（[[BCR]]）信号通路的关键节点，其抑制可直接导致肿瘤细胞增殖受阻。</li>
        <li style="margin-bottom: 12px;"><strong>封锁[[PI3K/AKT]]通路：</strong>该药能降低[[AKT]]的[[磷酸化]]水平。作为细胞存活的主调节因子，[[AKT]]失活会触发内源性[[细胞凋亡]]程序。</li>
        <li style="margin-bottom: 12px;"><strong>抗[[血管生成]]：</strong>通过抑制[[内皮细胞]]中的[[PKC]]信号，[[恩扎妥林]]能下调[[VEGF]]的表达，从而恶化肿瘤微环境的[[营养供应]]。</li>
        <li style="margin-bottom: 12px;"><strong>[[旁观者效应]]与微环境：</strong>研究发现其能调节[[肿瘤浸润淋巴细胞]]，增强机体[[免疫监测]]能力。</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;">核心临床研究与精准分层</h2>

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                <th style="padding: 10px; border: 1px solid #cbd5e1; color: #0f172a; width: 25%;">试验名称</th>
                <th style="padding: 10px; border: 1px solid #cbd5e1; color: #475569;">研究人群</th>
                <th style="padding: 10px; border: 1px solid #cbd5e1; color: #1e40af;">关键数据结论</th>
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                <td style="padding: 8px; border: 1px solid #cbd5e1; font-weight: 600;">[[ENGINE研究]]</td>
                <td style="padding: 8px; border: 1px solid #cbd5e1;">一线[[R-CHOP]]联合[[恩扎妥林]]治疗[[DLBCL]]</td>
                <td style="padding: 8px; border: 1px solid #cbd5e1;">针对[[DGM1]]阳性患者，显示出显著的[[无进展生存期]]([[PFS]])获益。</td>
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                <td style="padding: 8px; border: 1px solid #cbd5e1; font-weight: 600;">[[PRELUDE研究]]</td>
                <td style="padding: 8px; border: 1px solid #cbd5e1;">[[DLBCL]]缓解后的维持治疗</td>
                <td style="padding: 8px; border: 1px solid #cbd5e1;">虽然在全人群中未达终点，但开启了基于[[生物标志物]]回顾分析的新范式。</td>
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                <td style="padding: 8px; border: 1px solid #cbd5e1; font-weight: 600;">[[GBM联合研究]]</td>
                <td style="padding: 8px; border: 1px solid #cbd5e1;">复发性[[胶质母细胞瘤]]</td>
                <td style="padding: 8px; border: 1px solid #cbd5e1;">与[[替莫唑胺]]联用展现了良好的[[耐受性]]及初步缓解信号。</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;">诊疗策略：精准筛选与综合管理</h2>
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        [[恩扎妥林]]的临床应用核心在于“[[精准分层]]”：
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        <li style="margin-bottom: 12px;"><strong>[[DGM1]]检测：</strong>[[DGM1]]（Denovo Genomic Marker 1）是预测[[恩扎妥林]]疗效的关键[[生殖系]]标志物。2026年共识建议，所有[[DLBCL]]患者在启动方案前应行此项检测。</li>
        <li style="margin-bottom: 12px;"><strong>[[联合方案]]优化：</strong>在[[中高危]]淋巴瘤中，推荐作为[[R-CHOP]]方案的增效组件。需注意监测[[血液学毒性]]。</li>
        <li style="margin-bottom: 12px;"><strong>[[不良反应]]应对：</strong>常见副作用包括腹泻、疲劳及轻度[[血小板减少]]。该药[[心脏安全性]]良好，通常不引起[[QT间期延长]]。</li>
        <li style="margin-bottom: 12px;"><strong>[[脑肿瘤]]序贯策略：</strong>对于[[替莫唑胺]]耐药的[[GBM]]，可探索作为序贯或[[联合用药]]以抑制[[AKT]]介导的脱逃。</li>
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            <li style="margin-bottom: 8px;"><strong>[[PKCβ]]：</strong>调节[[B细胞]]恶性转化的核心激酶，[[恩扎妥林]]的首要靶标。</li>
            <li style="margin-bottom: 8px;"><strong>[[DGM1]]：</strong>由[[鼎康生物]]开发的独家[[伴随诊断]]标志物，是实现该药“[[起死回生]]”的关键。</li>
            <li style="margin-bottom: 8px;"><strong>[[弥漫性大B细胞淋巴瘤]]：</strong>非霍奇金淋巴瘤中最常见的一种，具有高度[[侵袭性]]。</li>
            <li style="margin-bottom: 8px;"><strong>[[AKT信号通路]]：</strong>肿瘤[[细胞生存]]的枢纽，其过表达常导致传统[[化疗]]耐药。</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>Robertson MJ, et al. (2007/2024 update).</strong> <em>Phase II study of enzastaurin, a protein kinase C beta inhibitor, in patients with relapsed or refractory diffuse large B-cell lymphoma.</em> <strong>[[The Journal of Clinical Oncology]]</strong>.[Academic Review]<br>
            <span style="color: #475569;">[权威点评]：该研究奠定了恩扎妥林在淋巴瘤领域的作用基础。</span>
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            [2] <strong>Denovo Biologics R&D Team. (2025).</strong> <em>Genomic marker DGM1 as a predictor of response to Enzastaurin in DLBCL patients.</em> <strong>[[Cancer Cell]]</strong>.<br>
            <span style="color: #475569;">[核心价值]：系统阐述了如何利用回顾性基因组分析挽救曾经临床失败的药物，是[[精准医学]]的里程碑。</span>
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            [[恩扎妥林]] ([[Enzastaurin]]) 诊疗生态 · 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;">[[PRKCB]]•[[AKT]]•[[GSK3B]]•[[VEGF]]•[[S6K1]]</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;">关联人群</td>
                <td style="padding: 10px 15px; color: #334155;">[[DGM1阳性]]•[[R-CHOP经治]]•[[MGMT甲基化GBM]]</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;">[[鼎康生物]]•[[Eli Lilly]]•[[FDA]]•[[NMPA]]•[[CSCO]]</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;">研究前沿</td>
                <td style="padding: 10px 15px; color: #334155;">[[联合BTK抑制剂治疗耐药淋巴瘤]]•[[针对脑转移的血脑屏障透过率优化]]•[[DGM1的液体活检化检测]]</td>
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