Gkolfinopoulos Stavros, Mountzios Giannis
Medical Oncology Department, Heraklion University Hospital, Heraklion, Greece.
Medical Oncology Department, 251 Air Force General Hospital, Athens, Greece.
Ann Transl Med. 2018 Apr;6(8):142. doi: 10.21037/atm.2018.04.28.
Lung cancer remains the leading cause of cancer-related death in men and women, despite its constantly declining rates in incidence and mortality in the developed world. The past decade has witnessed an unprecedented rise in the development of molecular targeted therapies in various types of tumors. In non-small cell lung cancer (NSCLC), the greatest paradigm shift is the implementation of and tyrosine kinase inhibitors in the first line and subsequent lines of therapy, with impressive results. Though less frequent than the molecular alterations in the aforementioned genes, a number of aberrations in potential oncogenic drivers has been discovered, namely mutations in the genes , , , and , and rearrangements and , and gene amplifications. A great number of clinical trials are currently underway, evaluating agents specifically designed to target these alterations, with mixed results so far. The greatest cumulative benefit offered by these trials is that, despite their success or failure in their objective goals, they have provided us with a better understanding of the complexity of the molecular intracellular processes, necessitating thus the accurate interpretation of the preclinical data in order to appropriately select the patients that may derive benefit from targeted treatment strategies.
肺癌仍然是男性和女性癌症相关死亡的主要原因，尽管在发达国家其发病率和死亡率持续下降。在过去十年中，各种类型肿瘤的分子靶向治疗发展出现了前所未有的增长。在非小细胞肺癌（NSCLC）中，最大的模式转变是在一线及后续治疗中应用 和 酪氨酸激酶抑制剂，并取得了令人瞩目的效果。尽管这些基因的分子改变不如上述基因频繁，但已经发现了一些潜在致癌驱动因素的异常，即 、 、 、 和 基因的突变，以及 、 和 基因重排和 、 和 基因扩增。目前正在进行大量临床试验，评估专门针对这些改变设计的药物，到目前为止结果不一。这些试验带来的最大累积益处在于，尽管它们在目标上有成功或失败，但它们让我们更好地理解了分子细胞内过程的复杂性，因此需要准确解读临床前数据，以便适当地选择可能从靶向治疗策略中获益的患者。
