Labgaa Ismail, Villanueva Augusto
Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
Division of Liver Diseases and Division of Hematology and Medical Oncology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
Discov Med. 2015 Apr;19(105):263-73.
Liver cancer has become the second cause of cancer-related death worldwide. Most patients are still diagnosed at intermediate or advanced stage, where potentially curative treatment options are not recommended. Unlike other solid tumors, there are no validated oncogenic addiction loops and the only systemic agent to improve survival in advanced disease is sorafenib. All phase 3 clinical trials testing molecular therapies after sorafenib have been negative, none of which selected patients based on predictive biomarkers of response. Theoretically, analysis of circulating cancer byproducts (e.g., circulating tumor cells, cell-free nucleic acids), namely "liquid biopsy," could provide easy access to molecular tumor information, improve patients' stratification and allow to assess tumor dynamics over time. Recent technical developments and preliminary data from other malignancies indicate that liquid biopsy might have a role in the future management of cancer patients.
肝癌已成为全球癌症相关死亡的第二大原因。大多数患者仍在中晚期被诊断出来，而在这个阶段不推荐使用可能治愈性的治疗方案。与其他实体瘤不同，目前尚无经过验证的致癌成瘾循环，且在晚期疾病中唯一能提高生存率的全身治疗药物是索拉非尼。所有在索拉非尼之后测试分子疗法的3期临床试验均为阴性，其中没有一项是根据反应预测生物标志物来选择患者的。从理论上讲，对循环肿瘤副产物（例如循环肿瘤细胞、游离核酸）进行分析，即“液体活检”，可以轻松获取分子肿瘤信息，改善患者分层，并能够评估肿瘤随时间的动态变化。其他恶性肿瘤的最新技术进展和初步数据表明，液体活检可能在癌症患者的未来管理中发挥作用。
