European Institute of Oncology IRCCS, Milan, Italy; University of Milan, Milan, Italy.
European Institute of Oncology IRCCS, Milan, Italy.
Cancer Treat Rev. 2021 Mar;94:102169. doi: 10.1016/j.ctrv.2021.102169. Epub 2021 Feb 20.
Precision medicine is progressively revolutionizing oncology, through the identification of biomarkers predictive of treatment response in cancer patients. For three of such biomarkers, namely NTRK-fusions, microsatellite instability and high tumor mutational burden, drugs have been approved by regulatory agencies regardless of tumor histology, realizing the paradigm of histology-agnostic actionability. Several additional biomarkers are being studied in a histology-agnostic manner, and may in the future expand this list. However, most available evidence suggest that histology-agnosticism may be the extreme of a continuous spectrum of actionability, rather than a binary quality. The present review recapitulates such evidence, highlighting opportunities and challenges posed by the emergence of the spectrum of biomarker actionability in the context of a prevalently histology-based oncology.
精准医学正在通过鉴定癌症患者治疗反应的生物标志物，逐渐改变肿瘤学。对于三种这样的生物标志物，即 NTRK 融合、微卫星不稳定性和高肿瘤突变负担，监管机构已经批准了药物，而不考虑肿瘤组织学，实现了组织学不可知的可操作性范例。还有一些额外的生物标志物正在以组织学不可知的方式进行研究，并且将来可能会扩大这一列表。然而，大多数现有证据表明，组织学不可知可能是可操作性的连续谱的极端情况，而不是二进制质量。本综述回顾了这些证据，强调了在以组织学为基础的肿瘤学为主导的背景下，生物标志物可操作性谱的出现所带来的机遇和挑战。
