The following information is obtained from: Guidelines for Clinical Application of Novel Antitumor Drugs (2021 Edition), Health and Health Commission of the People’s Republic of China
A notable feature of modern antitumor drugs is the emergence of a group of drugs that target abnormal molecular features – i.e., targeted drugs. The most representative drugs are tyrosine kinase inhibitors that target abnormalities in the epidermal growth factor signaling pathway. Currently, the commonly used small-molecule targeted drugs and large-molecule monoclonal antibody-based drugs can be divided into two major categories based on whether target testing is required (table below).
Commonly used small-molecule targeted drugs and large-molecule monoclonal antibody drugs
| Diseases | Drugs requiring target detection | Drugs that do not require target testing |
| Lung cancer | Gefitinib Erlotinib Ectatinib Afatinib Daclotinib Ocetinib Ametinib Vomitinib Crizotinib Arletinib Ceritinib Enzatinib Pulatinib Sevolitinib |
Bevacizumab recombinant human vascular endothelial inhibitor Anrotinib everolimus Navulizumab* Pabrolizumab*# dulvalizumab Atelelizumab*# Karilizumab* Tirelizumab* Sindilizumab* |
| Pleural mesothelioma | Navulizumab Epirimumab |
|
| Sorafenib Regorafenib Lenvatinib Donafinil Atelelizumab Sindilizumab Karilizumab Tirelizumab Bevacizumab |
||
| Esophageal cancer | Pabrolizumab | Karelizumab |
| Gastric cancer | Trastuzumab Vedicitumomab |
Apatinib Navritumomab |
| Imatinib Avatinib |
Rigofenib sunitinib Repetinib |
|
| Neuroendocrine tumors | Sunitinib everolimus Soventinib |
|
| Cetuximab Pabrolizumab |
Bevacizumab Regorafenib Furoquinitinib |
|
| Imatinib Dasatinib Nilotinib Giretinib |
Ibrutinib berintuzumab Vinecla |
|
| Rituximab vibutuximab |
Cidarbenclamide Ibrutinib bortezomib Sindilizumab carrilizumab Tirelizumab Zebutinib |
|
| Multiple myeloma | Bortezomib Lenalidomide Pomalidomide Thalidomide Ixazomib Daretuzumab |
|
| myeloproliferative disorders | Rukotinib | |
| Kidney cancer | |
Everolimus sorafenib sunitinib axitinib pegaptanib lenvatinib Navulizumab Pabrolizumab |
| Tirelizumab | Tiraplizumab Pabrolizumab |
|
| Prostate cancer | Olaparib | |
| Breast cancer | Trastuzumab Emtricitumomab Patuximab Initumumab Lapatinib pyrrolizidine Neratinib |
Piperacillin Abecedrine cidabendiamide |
| Melanoma |
Imatinib vimofenib Darafenib Trametinib |
Pabrolizumab Tremelimumab |
| Everolimus | ||
| Renal vascular smooth muscle lipoma associated with tuberous sclerosis | Everolimus | |
| Dixumab | ||
| Glandular follicular soft tissue sarcoma | Anlotinib | |
| Anlotinib | ||
| Anlotinib | ||
| Nituzumab | Trepleximab Carrilizumab |
|
| Thyroid cancer | Sorafenib lumefantrine Anrotinib |
|
| Navulizumab Pabrolizumab |
Cetuximab | |
| Ovarian cancer (first-line maintenance) | oraparib | Niraparib |
| Ovarian cancer [platinum-sensitive recurrence (PSR) maintenance] | Olaparib Niraparib Fluazopalli |
|
| Ovarian cancer (multiline recurrent therapy) | Flurazoparib Parmiparib |
*: Patients with EGFR mutations and positive ALK fusions need to be excluded.
#: PD-L1 expression needs to be tested before pabrolizumab monotherapy and atelelizumab monotherapy use.
For drugs with a clear target of action, the principle of target testing must be followed before use. The instrumentation, diagnostic reagents and testing methods used for testing should be approved by the State Drug Administration, especially those validated by concomitant diagnosis. Drugs should not be used blindly without the relevant tests.