Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
State Key Laboratory of Translational Oncology, Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong SAR, China.
Clin Oncol (R Coll Radiol). 2020 Jan;32(1):e1-e9. doi: 10.1016/j.clon.2019.07.014. Epub 2019 Jul 30.
Lung cancer is a common cancer associated with high mortality rates worldwide. Unfortunately, it usually presents at a late stage, precluding the chance of curative therapy. The discovery of oncogenic driver mutations in patients with non-small cell lung cancer over the past 20 years has led to new molecular targeted therapies that have dramatically improved treatment efficacy and quality of life. New generations of therapy that target the drug-resistant mutations have also quickly evolved, benefiting patients who are refractory or intolerant to first-line targeted therapy. Eastern patients, from Southeast Asia, Japan and China, are known to have a higher incidence of epidermal growth factor receptor mutation. Therefore, compared with the West, more patients would benefit from these recent advances. In contrast, survival of patients without driver mutations has benefited from advances in novel therapeutics, including the immune checkpoint inhibitors. The current review aims to highlight the recent developments in the management of advanced-stage non-small cell lung cancer and to compare the differences in clinical practice between Eastern and Western countries.
肺癌是一种常见的癌症,全球死亡率较高。不幸的是,它通常在晚期出现,排除了治愈性治疗的机会。在过去的 20 年中,在非小细胞肺癌患者中发现了致癌驱动基因突变,这导致了新的分子靶向治疗,极大地提高了治疗效果和生活质量。针对耐药突变的新一代治疗方法也迅速发展,使对一线靶向治疗有抗药性或不耐受的患者受益。来自东南亚、日本和中国的东亚患者,已知表皮生长因子受体突变的发病率较高。因此,与西方相比,更多的患者将受益于这些最新进展。相比之下,新型治疗方法的进展使没有驱动突变的患者的生存受益,包括免疫检查点抑制剂。本文旨在强调晚期非小细胞肺癌治疗的最新进展,并比较东西方国家临床实践的差异。