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预测性分子肿瘤检测:实验室与临床应用之间的障碍有哪些?

Predictive Molecular Tumour Testing: What Are the Obstacles between Bench and Bedside?

作者信息

Mileshkin Linda, Shah Bhaumik, Michael Michael

机构信息

Division of Cancer Medicine, Peter MacCallum Cancer Centre, St. Andrews Place, East Melbourne, VIC 3002, Australia.

出版信息

Chemother Res Pract. 2012;2012:838509. doi: 10.1155/2012/838509. Epub 2012 May 14.

DOI:10.1155/2012/838509
PMID:22666589
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3359779/
Abstract

There have been many exciting new breakthroughs in understanding tumour biology. This has opened up the possibility of personalized treatment for people with certain tumours. The epidermal growth factor receptor (EGFR) and K-ras are two such targets that can help classify tumours on a molecular basis and guide treatment decisions. However, there are still questions about how best to implement new molecular tests like these to characterize tumours in clinical practice. Potential obstacles include availability of good quality tissue specimens, access to the right test, and consensus about interpretation, funding, and availability. In this paper, we review these issues, by discussing these two examples in detail and suggest some actions for addressing potential barriers.

摘要

在肿瘤生物学的理解方面已经有了许多令人兴奋的新突破。这为特定肿瘤患者的个性化治疗开辟了可能性。表皮生长因子受体(EGFR)和K-ras就是这样两个靶点,它们可以帮助在分子基础上对肿瘤进行分类并指导治疗决策。然而,关于如何在临床实践中最好地应用这类新的分子检测来表征肿瘤,仍然存在问题。潜在的障碍包括高质量组织标本的可获得性、获得正确检测的途径、关于解读、资金和可获得性的共识。在本文中,我们通过详细讨论这两个例子来审视这些问题,并提出一些应对潜在障碍的行动建议。

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本文引用的文献

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Canadian Expert Group consensus recommendations: KRAS testing in colorectal cancer.加拿大专家组共识推荐意见:结直肠癌中的 KRAS 检测。
Curr Oncol. 2011 Aug;18(4):e180-4. doi: 10.3747/co.v18i4.779.
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KRAS and BRAF mutation analysis in metastatic colorectal cancer: a cost-effectiveness analysis from a Swiss perspective.转移性结直肠癌中 KRAS 和 BRAF 突变分析:瑞士视角的成本效益分析。
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Concordance of predictive markers for EGFR inhibitors in primary tumors and metastases in colorectal cancer: a review.探讨结直肠癌原发灶和转移灶中表皮生长因子受体抑制剂预测标志物的一致性:综述。
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Increased detection sensitivity for KRAS mutations enhances the prediction of anti-EGFR monoclonal antibody resistance in metastatic colorectal cancer.KRAS 基因突变检测敏感性增加可增强对转移性结直肠癌抗 EGFR 单克隆抗体耐药性的预测。
Clin Cancer Res. 2011 Jul 15;17(14):4901-14. doi: 10.1158/1078-0432.CCR-10-3137. Epub 2011 Jun 1.
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From clinical trials to clinical practice: predictors of response to erlotinib in advanced non-small cell lung cancer patients pretreated with chemotherapy.从临床试验到临床实践:接受过化疗的晚期非小细胞肺癌患者对厄洛替尼反应的预测因素
Tumori. 2011 Mar-Apr;97(2):160-5. doi: 10.1177/030089161109700205.
8
Survival benefit with erlotinib maintenance therapy in patients with advanced non-small-cell lung cancer (NSCLC) according to response to first-line chemotherapy.一线化疗缓解情况对晚期非小细胞肺癌(NSCLC)患者厄洛替尼维持治疗生存获益的影响。
Ann Oncol. 2012 Feb;23(2):388-94. doi: 10.1093/annonc/mdr125. Epub 2011 May 24.
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J Clin Oncol. 2011 May 20;29(15):2066-70. doi: 10.1200/JCO.2010.32.6181. Epub 2011 Apr 11.