Clinical Pharmacology and Regulatory Science, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
Institute for Medical Regulatory Science, Organization for University Research Initiatives, Waseda University, Tokyo, Japan.
Curr Treat Options Oncol. 2021 Jun 10;22(8):71. doi: 10.1007/s11864-021-00869-6.
Lung cancer is the most common form of cancer in humans and the leading cause of cancer-related death worldwide. Traditionally, lung cancer has been diagnosed as either small cell lung cancer (SCLC) or non-small cell lung cancer (NSCLC). However, recent developments in molecular pathology have revolutionized the diagnosis and treatment of the disease, thus improving patient prognosis and increasing the number of survivors. In advanced NSCLC cases, molecularly targeted drugs for patients with positive driver gene mutation/rearrangement, and immune checkpoint inhibitors for those with a positive biomarker, have changed the standard of care. SCLC is a highly malignant entity. In addition to the chemotherapy and radiotherapy, immune checkpoint inhibitors have recently provided some hope for extended-stage SCLC. Smoking cessation is related to decreased morbidity. However, early metastasis remains a significant challenge. Recently, cancer therapy-related cardiovascular disease (CTRCD) has emerged as diverse pathophysiology, including fulminant myocarditis, fatal arrhythmia, pericarditis, hypertension, and thrombosis, that emerged with modern lung cancer therapies. Cardio-oncology is a new interdisciplinary collaboration to develop methodologies to manage cardiovascular risk factors and CTRCDs with the common goal of minimizing unnecessary interruption of cancer treatment and maximizing outcomes of lung cancer survivors.
肺癌是人类最常见的癌症形式，也是全球癌症相关死亡的主要原因。传统上，肺癌分为小细胞肺癌（SCLC）或非小细胞肺癌（NSCLC）。然而，分子病理学的最新进展彻底改变了疾病的诊断和治疗，从而改善了患者的预后并增加了幸存者的数量。在晚期 NSCLC 病例中，针对具有阳性驱动基因突变/重排的患者的分子靶向药物，以及针对具有阳性生物标志物的患者的免疫检查点抑制剂，已经改变了治疗标准。SCLC 是一种高度恶性的实体瘤。除了化疗和放疗外，免疫检查点抑制剂最近为广泛期 SCLC 提供了一些希望。戒烟与发病率降低有关。然而，早期转移仍然是一个重大挑战。最近，与癌症治疗相关的心血管疾病（CTRCD）出现了各种病理生理学表现，包括暴发性心肌炎、致命性心律失常、心包炎、高血压和血栓形成，这些都是随着现代肺癌治疗而出现的。肿瘤心脏病学是一种新的跨学科合作，旨在开发管理心血管危险因素和 CTRCD 的方法，共同目标是尽量减少癌症治疗的不必要中断，最大限度地提高肺癌幸存者的治疗效果。
