Economopoulou Panagiota, Mountzios Giannis
Medical Oncology Department, "Attikon" University Hospital, Athens, Greece.
Medical Oncology Department, 251 Air Force General Hospital, Athens, Greece.
Ann Transl Med. 2018 Apr;6(8):138. doi: 10.21037/atm.2017.11.07.
Lung cancer remains the leading cause of cancer related death worldwide. Despite broad advances in diagnostics and therapy, the five-year overall survival for patients with advanced non-small cell lung cancer (NSCLC) has not significantly changed over the past few years. Following the decoding of human cancer genome and the advent of therapies targeting driver mutations, the selection of systemic therapy changed from "one size fits all" approach to a more precise selection of biologic therapies targeting distinct genetic profiles. Molecular alterations can be targeted by specific drugs that are administered orally, have higher response rates and a better toxicity profile compared to standard chemotherapy. More recently, better understanding of the interactions between tumor cells and the immune system has led to the development of new therapeutic strategies that enhance the body's own immune response towards antitumor immunity. Robust data on these new drugs have been generated not only in the second-line setting, but also as first line therapy and in combination with standard therapies. In this review, we aim to illustrate a comprehensive up-to-date within the newest advances in the field of NSCLC, with the view to educate new practitioners and stimulate new thoughts for clinical trials.
肺癌仍是全球癌症相关死亡的主要原因。尽管在诊断和治疗方面取得了广泛进展,但在过去几年中,晚期非小细胞肺癌(NSCLC)患者的五年总生存率并未显著改变。随着人类癌症基因组的解码以及针对驱动突变的疗法的出现,全身治疗的选择从“一刀切”的方法转变为更精确地选择针对不同基因特征的生物疗法。与标准化疗相比,特定药物可针对分子改变,这些药物口服给药,具有更高的缓解率和更好的毒性特征。最近,对肿瘤细胞与免疫系统之间相互作用的更好理解导致了新治疗策略的发展,这些策略增强了机体自身针对抗肿瘤免疫的免疫反应。关于这些新药的有力数据不仅在二线治疗中产生,也在一线治疗以及与标准疗法联合使用时产生。在本综述中,我们旨在阐述NSCLC领域最新进展的全面最新情况,以期教育新从业者并激发临床试验的新想法。