Department of Oncology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, 510280 China; The First Clinical Medical School of Southern Medical University, Guangzhou, Guangdong, 510515 China.
Department of Oncology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, 510280 China.
Biomed Pharmacother. 2022 May;149:112909. doi: 10.1016/j.biopha.2022.112909. Epub 2022 Apr 5.
In recent years, the application of targeted therapy has greatly improved the survival of NSCLC patients with known tumor mutations. However, the plasticity of tumor cells can drive them to transform into a phenotypic state that is no longer targeted by drugs. One of the mechanisms by which drug resistance occurs is the transformation from NSCLC to SCLC. This seems to occur because of the selection pressure exerted by the drugs. However, the transformation has also been observed in non-targeted patients, which challenges the origin of transformed SCLC. In the present study, the current clinical understanding of transformed SCLC is summarized along with the current understanding of its genome status and cloning history in cancer progression. This was done to explore the origins of transformed SCLC, find key molecular markers to predict the occurrence of the transformation, and permit timely adjustment of patients' treatment plans. Besides, the current clinical trials on transformed SCLC are discussed. Finally, recommendations are made on the problems that need to be solved to improve the diagnosis and treatment of patients with transformed SCLC.
近年来，靶向治疗的应用极大地提高了已知肿瘤突变的 NSCLC 患者的生存率。然而，肿瘤细胞的可塑性可以促使它们转变为一种不再被药物靶向的表型状态。耐药性发生的机制之一是从 NSCLC 向 SCLC 的转变。这似乎是由于药物施加的选择压力所致。然而，在非靶向治疗的患者中也观察到了这种转变，这对转化而来的 SCLC 的起源提出了挑战。在本研究中，总结了目前对转化型 SCLC 的临床认识，以及对其基因组状态和癌症进展过程中克隆历史的认识。这是为了探索转化型 SCLC 的起源，寻找预测转化发生的关键分子标志物，并允许及时调整患者的治疗计划。此外，还讨论了目前针对转化型 SCLC 的临床试验。最后，就需要解决的问题提出了建议，以改善转化型 SCLC 患者的诊断和治疗。
