Department of Pathology & Genomic Medicine, The Methodist Hospital, Houston, Texas, USA.
Arch Pathol Lab Med. 2012 Dec;136(12):1482-91. doi: 10.5858/arpa.2012-0508-RA.
The advent of genotype-based therapy and predictive biomarkers for lung cancer has thrust the pathologist into the front lines of precision medicine for this deadly disease.
To provide the clinical background, current status, and future perspectives of molecular targeted therapy for lung cancer patients, including the pivotal participation of the pathologist.
Data were obtained from review of the pertinent peer-reviewed literature.
First-generation tyrosine kinase inhibitors have produced clinical response in a limited number of non-small cell lung cancers demonstrated to have activating mutations of epidermal growth factor receptor or anaplastic lymphoma kinase rearrangements with fusion partners. Patients treated with first-generation tyrosine kinase inhibitors develop acquired resistance to their therapy. Ongoing investigations of second-generation tyrosine kinase inhibitors and new druggable targets as well as the development of next-generation genotyping and new antibodies for immunohistochemistry promise to significantly expand the pathologist's already crucial role in precision medicine of lung cancer.
基于基因型的治疗方法和肺癌预测性生物标志物的出现，使病理学家成为这种致命疾病精准医疗的第一线。
为肺癌患者的分子靶向治疗提供临床背景、现状和未来展望，包括病理学家的关键参与。
数据来自对相关同行评议文献的回顾。
第一代酪氨酸激酶抑制剂在具有表皮生长因子受体激活突变或间变性淋巴瘤激酶重排与融合伙伴的有限数量的非小细胞肺癌中产生了临床反应。接受第一代酪氨酸激酶抑制剂治疗的患者对其治疗产生了获得性耐药。正在进行的第二代酪氨酸激酶抑制剂和新的可用药靶点的研究以及下一代基因分型和新的免疫组织化学抗体的开发有望显著扩大病理学家在肺癌精准医学中已经至关重要的作用。
