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KRAS与非小细胞肺癌个体化医疗的现状

KRAS AND THE REALITY OF PERSONALIZED MEDICINE IN NON-SMALL CELL LUNG CANCER.

作者信息

Kilgoz Havva O, Bender Guzide, Scandura Joseph M, Viale Agnes, Taneri Bahar

机构信息

Department of Biological Sciences, Eastern Mediterranean University, Famagusta, North Cyprus, via Mersin-10-Turkey.

Department of Medicine, Hematology-Oncology, Weill Cornell Medicine, NY, NY, 10065, USA.

出版信息

Mol Med. 2016 Sep;22:380-387. doi: 10.2119/molmed.2016.00151. Epub 2016 Jul 7.

Abstract

Lung cancer is the leading cause of mortality among all cancer types, worldwide. Latest available global statistics of World Health Organization report 1.59 million casualities in 2012 alone. Worldwide, 1 in 5 cancer deaths are caused by lung cancer. In 2016, in USA alone, estimated new cases of lung cancer are 224,390, of which 158,080 are expected to result in death as reported by National Cancer Institute. Non-small cell lung cancer (NSCLC), a histological subtype, comprises of about 85% of all cases, which is nearly 9 out of 10 lung cancer patients. Efforts are underway to develop and improve targeted therapy strategies. Certain mutations are being clinically targeted such as those in and genes. However, one of the most frequently mutated genes in NSCLC is the oncogene, which is currently untargetable. Approximately 25% of all types of NSCLC tumors contain KRAS mutations, which remain as an undruggable challenge. These mutations are indicative of poor prognosis and confer negative response to standard chemotherapy. Furthermore, tumors harboring mutations are unlikely to respond to currently available targeted treatments such as Tyrosine Kinase Inhibitors. Therefore, there is a definitive, urgent need to generate new targeted therapy approaches for mutations. Current strategies have major limitations and evolve around targeting molecules upstream and downstream of . Direct targeting is not available in the clinic. Combination therapies of multiple agents are being sought. Concentrated efforts are needed to accelerate basic research and consecutive clinical trials to achieve effective targeting of .

摘要

肺癌是全球所有癌症类型中导致死亡的主要原因。世界卫生组织最新的全球统计数据显示,仅2012年就有159万例死亡病例。在全球范围内,五分之一的癌症死亡是由肺癌导致的。2016年,仅在美国,据美国国家癌症研究所报告,估计肺癌新发病例为224,390例,其中158,080例预计将导致死亡。非小细胞肺癌(NSCLC)是一种组织学亚型,约占所有病例的85%,即几乎每10名肺癌患者中有9名是非小细胞肺癌患者。目前正在努力开发和改进靶向治疗策略。某些突变正在临床上作为靶点,例如 基因和 基因中的突变。然而,NSCLC中最常见的突变基因之一是 癌基因,目前该基因无法被靶向治疗。所有类型的NSCLC肿瘤中约25%含有KRAS突变,这仍然是一个难以攻克的挑战。这些突变预示着预后不良,并对标准化疗产生阴性反应。此外,携带 突变的肿瘤不太可能对目前可用的靶向治疗药物(如酪氨酸激酶抑制剂)产生反应。因此,迫切需要针对 突变开发新的靶向治疗方法。目前的策略存在重大局限性,主要围绕靶向 基因上下游的分子展开。临床上尚无直接靶向治疗方法。目前正在寻求多种药物的联合治疗。需要集中精力加速基础研究和后续临床试验,以实现对 的有效靶向治疗。

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