Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, United States.
The Johns Hopkins University School of Medicine, United States.
Cancer Treat Rev. 2019 Aug;78:31-41. doi: 10.1016/j.ctrv.2019.07.002. Epub 2019 Jul 15.
Current classification and treatment of lung cancer rely increasingly on molecular and genetic testing. Obtaining tumor tissue is not always feasible and multiple biopsies are undesirable. In response to the demand for non-invasive molecular and genetic testing in cancer care, several liquid biopsy technologies, including circulating DNA (ctDNA), have been developed. ctDNA analysis is now technically feasible to be carried out in large scales and integrated into clinical practice owing to the advances in technology. Despite the challenges in improving test accuracy and cost-effectiveness, there are huge potentials for ctDNA analysis in lung cancer management. This review focuses on the clinical utility of ctDNA analysis in lung cancer, including early detection, monitoring treatment response and detecting residual disease, identification of genetic determinants for targeted therapy, and predicting efficacy of immune checkpoint blockade.
目前，肺癌的分类和治疗越来越依赖于分子和基因检测。获取肿瘤组织并不总是可行的，多次活检也不理想。为了满足癌症治疗中非侵入性分子和基因检测的需求，已经开发了几种液体活检技术，包括循环 DNA（ctDNA）。由于技术的进步，ctDNA 分析现在在技术上可行，可以大规模进行，并整合到临床实践中。尽管在提高检测准确性和成本效益方面存在挑战，但 ctDNA 分析在肺癌管理中有巨大的潜力。本综述重点介绍了 ctDNA 分析在肺癌中的临床应用，包括早期检测、监测治疗反应和检测残留疾病、鉴定靶向治疗的遗传决定因素，以及预测免疫检查点阻断的疗效。
