Domvri Kalliopi, Zarogoulidis Paul, Darwiche Kaid, Browning Robert F, Li Qiang, Turner J Francis, Kioumis Ioannis, Spyratos Dionysios, Porpodis Konstantinos, Papaiwannou Antonis, Tsiouda Theodora, Freitag Lutz, Zarogoulidis Konstantinos
1. Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
J Cancer. 2013 Nov 23;4(9):736-54. doi: 10.7150/jca.7734.
Lung cancer first line treatment has been directed from the non-specific cytotoxic doublet chemotherapy to the molecular targeted. The major limitation of the targeted therapies still remains the small number of patients positive to gene mutations. Furthermore, the differentiation between second line and maintenance therapy has not been fully clarified and differs in the clinical practice between cancer centers. The authors present a segregation between maintenance treatment and second line and present a possible definition for the term "maintenance" treatment. In addition, cancer cell evolution induces mutations and therefore either targeted therapies or non-specific chemotherapy drugs in many patients become ineffective. In the present work pathways such as epidermal growth factor, anaplastic lymphoma kinase, met proto-oncogene and PI3K are extensively presented and correlated with current chemotherapy treatment. Future, perspectives for targeted treatment are presented based on the current publications and ongoing clinical trials.
肺癌一线治疗已从非特异性细胞毒性双联化疗转向分子靶向治疗。靶向治疗的主要局限性仍然是基因突变呈阳性的患者数量较少。此外，二线治疗和维持治疗之间的区别尚未完全阐明，并且在不同癌症中心的临床实践中存在差异。作者提出了维持治疗和二线治疗之间的区分，并给出了“维持”治疗这一术语的可能定义。此外，癌细胞进化会诱导突变，因此在许多患者中，靶向治疗或非特异性化疗药物都会变得无效。在本研究中，广泛介绍了表皮生长因子、间变性淋巴瘤激酶、原癌基因met和PI3K等信号通路，并将其与当前的化疗治疗相关联。基于当前的出版物和正在进行的临床试验，还介绍了靶向治疗的未来前景。
