Guo Hanfei, Li Wenqian, Wang Bin, Chen Neifei, Qian Lei, Cui Jiuwei
Cancer Center, the First Hospital of Jilin University, Changchun 130021, China.
Department of Neurosurgery, the First Hospital of Jilin University, Changchun 130021, China.
Chin J Cancer Res. 2021 Oct 31;33(5):574-582. doi: 10.21147/j.issn.1000-9604.2021.05.04.
Curative therapy was not previously available for patients with advanced non-small cell lung cancer (NSCLC); thus, the concept of minimal/measurable (or molecular) residual disease (MRD) was not applicable to these patients. However, advances in targeted and immunotherapy have revolutionized the treatment landscape for patients with advanced NSCLC, with emerging evidence of long-term survival and even the hope of complete remission (CR) by imaging examination. The latest research shows that patients with oligometastatic lung cancer can benefit from local treatment. After removing the lesions, the choice of follow-up therapy and monitoring of the lesions could remain uncertain. MRD plays a role in identifying early-stage NSCLC patients with high risks of recurrence and determining adjuvant therapy after radical treatment. In recent years, evidence has been accumulating regarding the use of circulating cell-free tumor DNA (ctDNA) to assess MRD in solid tumors. This study discussed the possible applications of ctDNA-based MRD monitoring in advanced NSCLC and described the current challenges and unresolved problems in the application of MRD in advanced NSCLC.
先前晚期非小细胞肺癌（NSCLC）患者没有可用的治愈性疗法；因此，最小/可测量（或分子）残留疾病（MRD）的概念不适用于这些患者。然而，靶向治疗和免疫治疗的进展彻底改变了晚期NSCLC患者的治疗格局，有新证据表明患者可长期存活，甚至通过影像学检查有望实现完全缓解（CR）。最新研究表明，寡转移性肺癌患者可从局部治疗中获益。在切除病灶后，后续治疗的选择以及对病灶的监测仍可能存在不确定性。MRD在识别复发风险高的早期NSCLC患者以及确定根治性治疗后的辅助治疗方面发挥着作用。近年来，关于使用循环游离肿瘤DNA（ctDNA）评估实体瘤MRD的证据不断积累。本研究讨论了基于ctDNA的MRD监测在晚期NSCLC中的可能应用，并描述了MRD在晚期NSCLC应用中的当前挑战和未解决的问题。
