Weinstein I Bernard, Joe Andrew K
College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
Nat Clin Pract Oncol. 2006 Aug;3(8):448-57. doi: 10.1038/ncponc0558.
There has been considerable progress in the systemic treatment of cancer because of the rapid development and clinical application of molecular targeted agents. Although patients with a particular type and stage of cancer are often treated as a single group, more-specific therapy is being considered, as subsets of these patients who are more likely to benefit from treatment with particular agents are being identified. We previously introduced the concept of 'oncogene addiction' to explain how some cancers that contain multiple genetic, epigenetic, and chromosomal abnormalities are dependent on or 'addicted' to one or a few genes for both maintenance of the malignant phenotype and cell survival. Thus, reversal of only one or a few of these abnormalities can inhibit cancer cell growth and in some cases translate to improved survival rates. This review summarizes current experimental and clinical evidence for the concept of oncogene addiction and describes molecular mechanisms that may explain this phenomenon. In addition, we discuss how high-throughput screening methods, including gene-expression profiling and proteomics, and emerging methods for analyzing complex cellular networks can be used to identify the state of oncogene addiction, i.e. the 'Achilles' heel,' in specific cancers. Finally, we discuss the use of molecular targeted agents in combination with other anticancer agents as a strategy to optimize therapy and prevent disease recurrence.
由于分子靶向药物的快速发展和临床应用,癌症的系统治疗取得了显著进展。尽管特定类型和阶段的癌症患者通常被作为一个单一群体进行治疗,但随着越来越多可能从特定药物治疗中获益的患者亚组被识别出来,人们开始考虑更具针对性的治疗方法。我们之前引入了“癌基因成瘾”的概念,以解释一些包含多种遗传、表观遗传和染色体异常的癌症如何依赖于一个或几个基因来维持恶性表型和细胞存活,即“成瘾”。因此,仅逆转其中一种或几种异常就可以抑制癌细胞生长,在某些情况下还能提高生存率。这篇综述总结了目前关于癌基因成瘾概念的实验和临床证据,并描述了可能解释这一现象的分子机制。此外,我们还讨论了如何利用高通量筛选方法,包括基因表达谱分析和蛋白质组学,以及用于分析复杂细胞网络的新兴方法,来识别特定癌症中的癌基因成瘾状态,即“阿喀琉斯之踵”。最后,我们讨论了将分子靶向药物与其他抗癌药物联合使用作为优化治疗和预防疾病复发策略的应用。