Department of Oncology, University Hospital Zurich, Zurich, Switzerland.
EORTC Headquarters, Brussels, Belgium.
Cancer Treat Rev. 2015 Feb;41(2):129-35. doi: 10.1016/j.ctrv.2014.12.004. Epub 2014 Dec 16.
Despite intense efforts, the socioeconomic burden of cancer remains unacceptably high and treatment advances for many common cancers have been limited, suggesting a need for a new approach to drug development. One issue central to this lack of progress is the heterogeneity and genetic complexity of many tumours. This results in considerable variability in therapeutic response and requires knowledge of the molecular profile of the tumour to guide appropriate treatment selection for individual patients. While recent advances in the molecular characterisation of different cancer types have the potential to transform cancer treatment through precision medicine, such an approach presents a major economic challenge for drug development, since novel targeted agents may only be suitable for a small cohort of patients. Identifying the patients who would benefit from individual therapies and recruiting sufficient numbers of patients with particular cancer subtypes into clinical trials is challenging, and will require collaborative efforts from research groups and industry in order to accelerate progress. A number of molecular screening platforms have already been initiated across Europe, and it is hoped that these networks, along with future collaborations, will benefit not only patients but also society through cost reductions as a result of more efficient use of resources. This review discusses how current developments in translational oncology may be applied in clinical practice in the future, assesses current programmes for the molecular characterisation of cancer and describes possible collaborative approaches designed to maximise the benefits of translational science for patients with cancer.
尽管付出了巨大努力,但癌症的社会经济负担仍然高得令人无法接受,许多常见癌症的治疗进展也受到限制,这表明需要采取新的药物开发方法。导致这一进展缓慢的一个核心问题是许多肿瘤的异质性和遗传复杂性。这导致治疗反应存在相当大的差异,需要了解肿瘤的分子特征,以指导为个别患者选择适当的治疗方法。虽然不同癌症类型的分子特征的最新进展有可能通过精准医学来改变癌症治疗,但这种方法对药物开发提出了重大的经济挑战,因为新型靶向药物可能只适用于一小部分患者。确定哪些患者将从个体化治疗中受益,并招募足够数量的具有特定癌症亚型的患者参加临床试验具有挑战性,这需要研究小组和行业的协作努力,以加速进展。欧洲已经启动了多个分子筛选平台,希望这些网络以及未来的合作不仅能使患者受益,还能通过更有效地利用资源来降低成本,从而使整个社会受益。这篇综述讨论了未来如何将转化肿瘤学的最新进展应用于临床实践,评估了癌症分子特征的当前方案,并描述了旨在使癌症患者从转化科学中获得最大收益的可能的合作方法。