胃肠道恶性肿瘤的分子靶点——病理学家视角。

Molecular targets in GI malignancies - A pathologist's perspective.

机构信息

Department of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Indian J Pathol Microbiol. 2021 Jun;64(Supplement):S43-S51. doi: 10.4103/IJPM.IJPM_1239_20.

DOI:10.4103/IJPM.IJPM_1239_20

PMID:34135137

Abstract

Newer molecular diagnostics and improved understanding of cancer pathogenesis have identified multiple pathways that can be potentially targeted with the use of novel therapeutics in development. These developments have ushered cancer therapeutics in newer era of personalized medicine. Same is reflected on current management strategies for advanced gastrointestinal malignancies. Molecular profiling for BRAF and RAS is standard for colorectal cancer while Her2 and PDL1 status is needed for planning therapy of advanced gastroesophageal cancers. Tissue agnostic markers like MSI, TMB and NTRK are making headways in therapeutic armamentarium. While newer targeted therapies against FGFR, EGFR, PI3K-AKT, DDR pathways are showing promising results in initial studies. Here we review traditional as well as upcoming molecular markers in field of GI malignancies, methods of testing and evidence for rational use in clinical practice.

摘要

新的分子诊断技术和对癌症发病机制的深入了解，已经确定了多个潜在的治疗靶点，新型治疗药物也正在开发中。这些发展使癌症治疗进入了个性化医学的新时代。目前，晚期胃肠道恶性肿瘤的治疗策略也反映了这一趋势。BRAF 和 RAS 的分子谱分析是结直肠癌的标准检测，而 Her2 和 PDL1 状态则是制定晚期胃食管癌症治疗计划的必要条件。组织非特异性标志物，如 MSI、TMB 和 NTRK，正在治疗武器库中取得进展。针对 FGFR、EGFR、PI3K-AKT、DDR 通路的新型靶向治疗在初步研究中显示出了有希望的结果。在这里，我们回顾了 GI 恶性肿瘤领域的传统和新兴分子标志物、检测方法以及在临床实践中合理应用的证据。