Department of Medicine, Division of Oncology, Stanford Cancer Institute/Stanford University School of Medicine, 875 Blake Wilbur Drive, Stanford, CA, 94305, USA.
Curr Treat Options Oncol. 2018 Jun 27;19(8):43. doi: 10.1007/s11864-018-0557-6.
The discovery of genomic alterations that drive the development and progression of non-small cell lung cancer (NSCLC) has transformed how we treat metastatic disease. However, the promise of precision medicine remains elusive for the most commonly mutated oncogene in NSCLC, KRAS. This is perhaps due to the substantial heterogeneity within the broader genomic context of KRAS-mutant NSCLC. At this time, approaches for treating metastatic KRAS-mutant NSCLC mirror those for treating NSCLC that lacks a known driver mutation, including standard chemotherapeutic and immunotherapeutic approaches. Ongoing research aims to define further subgroups of KRAS-mutant NSCLC based on mutation subtype and co-occurring mutations. These efforts offer the potential to optimize standard-of-care regimens within these emerging subgroups and harness innovative strategies to realize precision medicine in this setting.
导致非小细胞肺癌 (NSCLC) 发展和进展的基因组改变的发现改变了我们治疗转移性疾病的方式。然而，对于 NSCLC 中最常见的突变致癌基因 KRAS，精准医学的前景仍然难以捉摸。这也许是由于 KRAS 突变型 NSCLC 更广泛的基因组背景存在很大的异质性。此时，治疗转移性 KRAS 突变型 NSCLC 的方法与缺乏已知驱动突变的 NSCLC 相似，包括标准的化疗和免疫治疗方法。正在进行的研究旨在根据突变亚型和共同发生的突变进一步定义 KRAS 突变型 NSCLC 的亚组。这些努力有可能在这些新兴亚组中优化标准治疗方案，并利用创新策略在这种情况下实现精准医学。
