University of Bordeaux, INSERM U1218, ACTION Laboratory, IECB, 33600 Pessac, France.
Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, University of Torino, Torino, Italy; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA.
Trends Cancer. 2021 May;7(5):410-429. doi: 10.1016/j.trecan.2020.11.005. Epub 2020 Dec 9.
The discovery of oncogenic driver mutations led to the development of targeted therapies with non-small cell lung cancer (NSCLC) being a paradigm for precision medicine in this setting. Nowadays, the number of clinical trials focusing on targeted therapies for uncommon drivers is growing exponentially, emphasizing the medical need for these patients. Unfortunately, similar to what is observed with most targeted therapies directed against a driver oncogene, the clinical response is almost always temporary and acquired resistance to these drugs invariably emerges. Here, we review the biology of infrequent genomic actionable alterations in NSCLC as well as the current and emerging therapeutic options for these patients. Mechanisms leading to acquired drug resistance and future challenges in the field are also discussed.
致癌驱动突变的发现促使针对非小细胞肺癌(NSCLC)的靶向治疗的发展,这是精准医学在该领域的典范。如今,越来越多的临床试验聚焦于针对罕见驱动基因的靶向治疗,凸显了这些患者的医疗需求。不幸的是,与大多数针对驱动致癌基因的靶向治疗相似,临床反应几乎总是暂时的,这些药物不可避免地会产生获得性耐药。在这里,我们回顾 NSCLC 中罕见的基因组可操作改变的生物学特性,以及这些患者目前和新兴的治疗选择。还讨论了导致获得性药物耐药的机制和该领域未来的挑战。