David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
Semin Respir Crit Care Med. 2020 Jun;41(3):409-434. doi: 10.1055/s-0039-1700994. Epub 2020 May 25.
Lung cancer is a heterogeneous disease, and the availability of comprehensive genomic profiling has allowed for the characterization of its molecular subtypes. This has increased the ability to deliver "personalized medicines" by tailoring therapies to target driver mutations in a patient's cancer. The development of targeted therapies for non-small cell lung cancer (NSCLC) has helped define the era of precision medicine throughout oncology. This article aims to contextualize recent research and provide an updated summary of targeted therapies available for patients with NSCLC. With practitioners and clinical researchers in mind, we note standard of care therapies, important approvals, practice guidelines, and treatments in development. The first section discusses mutations in the epidermal growth factor receptor () gene, and the second section examines rearrangements in the anaplastic lymphoma kinase () and fusions. Finally, we explore the rarer molecular alterations in , , , , and . Given the many available therapies, it is important to understand the molecular alterations in NSCLC, and how to target them.
肺癌是一种异质性疾病，全面的基因组分析使我们能够对其分子亚型进行特征描述。这提高了通过针对患者癌症中的驱动突变来提供“个性化药物”的能力。针对非小细胞肺癌（NSCLC）的靶向治疗的发展帮助定义了整个肿瘤学的精准医学时代。本文旨在为最近的研究提供背景，并对 NSCLC 患者可用的靶向治疗进行更新总结。考虑到从业者和临床研究人员，我们注意到标准护理疗法、重要批准、实践指南和正在开发的治疗方法。第一节讨论了表皮生长因子受体（EGFR）基因的突变，第二节研究了间变性淋巴瘤激酶（ALK）和融合的重排。最后，我们探索了 、 、 、 、 中罕见的分子改变。鉴于有许多可用的疗法，了解 NSCLC 中的分子改变以及如何针对这些改变进行治疗非常重要。
