Pirker Robert, Filipits Martin
Department of Medicine I, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Cancer Metastasis Rev. 2016 Mar;35(1):141-50. doi: 10.1007/s10555-016-9612-6.
Personalized treatment of patients with advanced non-small-cell lung cancer based on clinical and molecular tumor features has entered clinical routine practice. The 2015 pathological classification of lung cancer mandates immunohistochemical and molecular analysis. Therapeutic strategies focused on inhibition of angiogenesis and growth factor receptor signaling. Inhibitors of angiogenesis and monoclonal antibodies directed against the epidermal growth factor receptor have shown efficacy in combination with chemotherapy. Mutations in the epidermal growth factor receptor and anaplastic lymphoma kinase have become clinically relevant therapeutic targets. Immune checkpoint inhibitors are also entering routine clinical practice. Identification of predictive biomarkers is essential and faces several challenges including tumor heterogeneity and dynamic changes of tumor features over time. Liquid biopsies may overcome some of these challenges in the future.
基于临床和分子肿瘤特征的晚期非小细胞肺癌患者个性化治疗已进入临床常规实践。2015年肺癌病理分类要求进行免疫组织化学和分子分析。治疗策略集中于抑制血管生成和生长因子受体信号传导。血管生成抑制剂和针对表皮生长因子受体的单克隆抗体已显示出与化疗联合使用的疗效。表皮生长因子受体和间变性淋巴瘤激酶的突变已成为具有临床意义的治疗靶点。免疫检查点抑制剂也正在进入常规临床实践。预测性生物标志物的识别至关重要，并且面临包括肿瘤异质性和肿瘤特征随时间动态变化在内的若干挑战。液体活检未来可能会克服其中一些挑战。
