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非小细胞肺癌的个体化医学。

Personalized medicine for non-small-cell lung cancer.

机构信息

Department of Clinical Oncology, Prince of Wales Hospital, Hong Kong, China.

出版信息

Expert Rev Anticancer Ther. 2010 Oct;10(10):1601-11. doi: 10.1586/era.10.76.

Abstract

Non-small-cell lung cancer (NSCLC) is a heterogeneous illness associated with a high mortality rate. Personalized therapy may improve treatment outcomes by identification of a specific genotypic anomaly and target-specific therapy. The most significant development in recent years was the discovery of activated EGF receptor (EGFR) mutations at exons 19 and 21. Patients with EGFR mutations respond dramatically to EGFR tyrosine kinase inhibitors such as gefitinib or erlotinib, resulting in longer progression-free survival. Multiple randomized studies, including the Iressa Pan-Asia Study and WJTOG3405, have confirmed the role of EGFR tyrosine kinase inhibitors as standard first-line therapy for patients with the EGFR mutation. In this article, we summarize the current nonpersonalized therapies and examine the available and investigational personalized therapies for patients with resectable early-stage, unresectable locally advanced, or metastatic disease.

摘要

非小细胞肺癌(NSCLC)是一种异质性疾病,死亡率较高。通过鉴定特定的基因异常和针对特定靶点的治疗,个体化治疗可能改善治疗效果。近年来最重要的进展是发现了外显子 19 和 21 处激活的表皮生长因子受体(EGFR)突变。EGFR 突变的患者对 EGFR 酪氨酸激酶抑制剂(如吉非替尼或厄洛替尼)反应明显,导致无进展生存期延长。包括 Iressa Pan-Asia 研究和 WJTOG3405 在内的多项随机研究证实,EGFR 酪氨酸激酶抑制剂作为 EGFR 突变患者标准一线治疗的地位。本文总结了目前的非个体化治疗方法,并探讨了可用于治疗可切除的早期、不可切除的局部晚期或转移性疾病患者的现有和正在研究的个体化治疗方法。

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