Multidisciplinary Thoracic Oncology Program, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27599, USA.
Clin Lung Cancer. 2010 May;11(3):149-59. doi: 10.3816/CLC.2010.n.019.
Novel therapies, particularly those that target vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR), have improved the treatment of advanced non-small-cell lung cancer (NSCLC). The search continues for biomarkers that can predict which patients are most likely to benefit from these therapies. At the same time, new research is helping to define how clinical and histopathologic features, such as ethnicity and histologic subtype, influence treatment decisions. Numerous studies have assessed potential biomarkers that may predict outcomes following treatment with anti-EGFR therapies, including mutations in EGFR and KRAS genes, EGFR gene copy number by fluorescence in situ hybridization, and EGFR protein expression by immunohistochemistry (IHC). Although mounting evidence supports the role of EGFR mutations in selecting therapy in clinical practice, in other cases, the emerging data have painted a complex and often contradictory picture, making it difficult to foresee how this information could be used in clinical practice. The discrepancies in published reports may be because of differences in patient populations or variations in methodology for assessing biomarkers; they also may reflect our incomplete understanding of the role of the EGFR pathway in NSCLC. Further assessment of these and other novel biomarkers is warranted to help define which patients with advanced NSCLC may derive the most benefit from targeted therapies.
新型疗法，特别是针对血管内皮生长因子(VEGF)和表皮生长因子受体(EGFR)的疗法，改善了晚期非小细胞肺癌(NSCLC)的治疗效果。目前仍在寻找生物标志物，以预测哪些患者最有可能从这些治疗中受益。与此同时，新的研究有助于确定临床和组织病理学特征(如种族和组织学亚型)如何影响治疗决策。许多研究评估了可能预测抗 EGFR 治疗后结果的潜在生物标志物，包括 EGFR 和 KRAS 基因突变、荧光原位杂交检测的 EGFR 基因拷贝数，以及免疫组织化学(IHC)检测的 EGFR 蛋白表达。尽管越来越多的证据支持 EGFR 突变在临床实践中选择治疗的作用，但在其他情况下，新兴数据描绘了一幅复杂且常常相互矛盾的画面，使得难以预见这些信息如何在临床实践中使用。发表的报告中的差异可能是由于患者人群的差异或评估生物标志物的方法学的差异；也可能反映了我们对 EGFR 通路在 NSCLC 中的作用的不完全了解。进一步评估这些和其他新型生物标志物是有必要的，以帮助确定哪些晚期 NSCLC 患者可能从靶向治疗中获益最大。
