Redmond Keara L, Papafili Anastasia, Lawler Mark, Van Schaeybroeck Sandra
Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Belfast, United Kingdom.
Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Belfast, United Kingdom.
Semin Oncol. 2015 Dec;42(6):896-908. doi: 10.1053/j.seminoncol.2015.09.028. Epub 2015 Sep 25.
The recent discovery of oncogenic drivers and subsequent development of novel targeted strategies has significantly added to the therapeutic armamentarium of anti-cancer therapies. Targeting BCR-ABL in chronic myeloid leukemia (CML) or HER2 in breast cancer has led to practice-changing clinical benefits, while promising therapeutic responses have been achieved by precision medicine approaches in EGFR mutant lung cancer, colorectal cancer and BRAF mutant melanoma. However, although initial therapeutic responses to targeted therapies can be substantial, many patients will develop disease progression within 6-12 months. An increasing application of powerful omics-based approaches and improving preclinical models have enabled the rapid identification of secondary resistance mechanisms. Herein, we discuss how this knowledge has translated into rational, novel treatment strategies for relapsed patients in genomically selected cancer populations.
致癌驱动因素的近期发现以及随后新型靶向策略的开发,极大地丰富了抗癌治疗的手段。在慢性髓性白血病(CML)中靶向BCR-ABL或在乳腺癌中靶向HER2已带来改变临床实践的益处,而在表皮生长因子受体(EGFR)突变的肺癌、结直肠癌和BRAF突变的黑色素瘤中,精准医学方法已取得了有前景的治疗反应。然而,尽管对靶向治疗的初始治疗反应可能很大,但许多患者会在6至12个月内出现疾病进展。基于强大组学方法的应用不断增加以及临床前模型的改进,使得能够快速识别继发性耐药机制。在此,我们讨论了这些知识如何转化为针对基因组选择的癌症人群中复发患者的合理、新型治疗策略。