Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL 60611, USA.
Am J Clin Pathol. 2011 Aug;136(2):228-38. doi: 10.1309/AJCPO66OIRULFNLZ.
Non-small cell lung cancer (NSCLC) is traditionally classified histologically, but until recently, the histologic subtype has had little impact on the selection of therapy. Drugs such as pemetrexed and bevacizumab are indicated for specific NSCLC subtypes, and this type of stratification represents the first step toward individualizing therapy in NSCLC. Beyond histologic features, the status of molecular targets, such as the epidermal growth factor receptor (EGFR) gene, has been shown to correlate with response to treatment with EGFR tyrosine kinase inhibitors in patients with relapsed or refractory disease and in the first-line therapy setting. New therapies targeting the EGFR and other molecular aberrations are under way to help define specific subsets of patients responsive to certain molecularly targeted treatments. The role of pathologists in guiding treatment decisions will increase because molecular profiling, together with pathologic and histologic analysis, represents the future of personalizing medicine for patients with NSCLC.
非小细胞肺癌（NSCLC）传统上是根据组织学进行分类的，但直到最近，组织学亚型对治疗的选择影响不大。培美曲塞和贝伐单抗等药物适用于特定的 NSCLC 亚型，这种分层代表了向 NSCLC 个体化治疗迈出的第一步。除了组织学特征外，分子靶点的状态，如表皮生长因子受体（EGFR）基因，已被证明与复发性或难治性疾病患者以及一线治疗中接受 EGFR 酪氨酸激酶抑制剂治疗的反应相关。针对 EGFR 和其他分子异常的新疗法正在进行中，以帮助确定对某些分子靶向治疗有反应的特定患者亚群。由于分子谱分析与病理和组织学分析一起代表了 NSCLC 患者个体化医疗的未来，因此病理学家在指导治疗决策方面的作用将会增加。
