Rivera S, Quéro L, Wong Hee Kam S, Maylin C, Deutsch E, Hennequin C
Service de cancérologie radiothérapie, hôpital Saint-Louis, Paris, France.
Cancer Radiother. 2011 Oct;15(6-7):527-35. doi: 10.1016/j.canrad.2011.07.234. Epub 2011 Aug 31.
Lung cancer is the leading cause of cancer-related death. Between 80-85% of lung cancers are non-small cell lung carcinomas. One third of the patients are diagnosed with locally advanced stage. In this condition, concomitant radio-chemotherapy is the standard treatment for patients with good performance status. Despite important improvements in the last years, non-small cell lung carcinoma prognosis remains poor, with high rates of both local recurrences and metastases. The heterogeneity of molecular characteristics of non-small cell lung carcinoma cells and a better knowledge of potential targets offer promising developments for new pharmacologic agents. Hereafter we will review the currently most studied pathways and the most promising ones for the treatment of locally advanced unresectable non-small cell lung carcinoma. Two of the most attractive pathways where new agents have been developed and assessed in combination with thoracic radiotherapy or radiochemotherapy are the EGFR pathway (either with the use of monoclonal antibodies or tyrosine kinase inhibitors) and the angiogenesis inhibition. The development of targeted agents could lead to individualized therapeutic combinations taking into account the intrinsic characteristics of tumor cells. Pharmacological modulation of tumour cells radiosensitivity by targeted therapies is only starting, but yet offers promising perspectives.
肺癌是癌症相关死亡的主要原因。80%-85%的肺癌为非小细胞肺癌。三分之一的患者被诊断为局部晚期。在这种情况下，同步放化疗是身体状况良好患者的标准治疗方法。尽管近年来有了重要进展，但非小细胞肺癌的预后仍然很差，局部复发和转移率都很高。非小细胞肺癌细胞分子特征的异质性以及对潜在靶点的更好了解为新型药物带来了有前景的发展。以下我们将综述目前研究最多的途径以及治疗局部晚期不可切除非小细胞肺癌最有前景的途径。已开发并与胸部放疗或放化疗联合评估新型药物的两个最具吸引力的途径是EGFR途径（使用单克隆抗体或酪氨酸激酶抑制剂）和血管生成抑制。靶向药物的开发可能会根据肿瘤细胞的内在特征导致个体化的治疗组合。靶向治疗对肿瘤细胞放射敏感性的药理调节才刚刚起步，但仍提供了有前景的前景。
