Das Satya, Horn Leora
2220 Pierce Avenue, 777 Preston Research Building, Nashville, TN 37232, USA.
Lung Cancer Manag. 2017 Jul;6(1):29-37. doi: 10.2217/lmt-2016-0019. Epub 2017 May 19.
The identification of driver mutations in patients with advanced non-small-cell lung cancer has changed the treatment outcomes for patients with actionable driver mutations. Lack of tissue at diagnosis, however, remains a central obstacle in making optimal treatment decisions in patients with advanced disease. Although the US FDA has approved one plasma-based test for detecting epidermal growth factor receptor mutations in patients with advanced stage disease, sensitivity of these assays remains mediocre, necessitating additional tissue testing and possible delays in patients with negative results. Serial monitoring for response and early detection of acquired resistance to targeted therapies is also possible with cell-free DNA, however the benefit of switching therapy prior to detection of changes on imaging is unknown currently.
晚期非小细胞肺癌患者驱动基因突变的鉴定改变了具有可操作驱动基因突变患者的治疗结果。然而，诊断时缺乏组织仍然是晚期疾病患者做出最佳治疗决策的主要障碍。尽管美国食品药品监督管理局（FDA）已批准一项基于血浆的检测用于检测晚期疾病患者的表皮生长因子受体突变，但这些检测的敏感性仍然一般，这就需要进行额外的组织检测，并且可能会使检测结果为阴性的患者出现治疗延迟。通过游离DNA进行反应的连续监测以及对靶向治疗获得性耐药的早期检测也是可行的，然而目前在影像学检测到变化之前更换治疗的益处尚不清楚。
