Xu Chenxin, Cao Haixia, Shi Chen, Feng Jifeng
The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Nanjing, Jiangsu Province, People's Republic of China.
Research Center for Clinical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, People's Republic of China.
Onco Targets Ther. 2019 Nov 8;12:9459-9471. doi: 10.2147/OTT.S226202. eCollection 2019.
The application of precision medicine in cancer treatment has partly succeeded in reducing the side effects of unnecessary chemotherapeutics and in improving the survival rate of patients. However, with the long-term use of therapy, the dynamically changing intratumoral and intertumoral heterogeneity eventually gives rise to therapeutic resistance. In recent years, a novel testing technology (termed liquid biopsy) using circulating tumor DNAs (ctDNAs) extracted from peripheral blood samples from patients with cancer has brought about new expectations to the medical community. Using ctDNAs, clinicians can trace the heterogeneity pattern to duly adjust individual therapy and prolong overall survival for patients with cancer. Technological advances in detecting and characterizing ctDNAs (eg, development of next-generation sequencing) have provided clinicians with a valuable tool for genotyping tumors individually and identifying genetic and epigenetic alterations of the entire tumor to capture mutations associated with therapeutic resistance.
精准医学在癌症治疗中的应用在一定程度上成功减少了不必要化疗的副作用,并提高了患者的生存率。然而,随着治疗的长期使用,肿瘤内和肿瘤间动态变化的异质性最终会导致治疗耐药性。近年来,一种利用从癌症患者外周血样本中提取的循环肿瘤DNA(ctDNA)的新型检测技术(称为液体活检)给医学界带来了新的期望。通过使用ctDNA,临床医生可以追踪异质性模式,以便适时调整个体化治疗方案,延长癌症患者的总生存期。检测和表征ctDNA的技术进步(如下一代测序技术的发展)为临床医生提供了一个有价值的工具,用于对肿瘤进行个体基因分型,并识别整个肿瘤的基因和表观遗传改变,以捕捉与治疗耐药性相关的突变。