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[分子肿瘤学专家组与诊疗一体化]

[Molecular tumor board and theranostics].

作者信息

Rumyantsev P O

机构信息

MMC Group of clinics.

出版信息

Probl Endokrinol (Mosk). 2023 Jan 9;68(6):5-11. doi: 10.14341/probl13220.

DOI:10.14341/probl13220
PMID:36689706
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9939957/
Abstract

Clinical oncology is currently undergoing a period of unprecedented change. Targeted therapy, and subsequently immunotherapy, has revolutionized the clinical course and outcome of many patients with solid cancer. Clinical oncology is inseparable from molecular oncology, the development of which is interconnected. Molecular tumor research proposes the most precise, effective and lesser toxic antitumor therapy regimen is an extremely urgent clinical task, especially in life-threatening and resistant to other types of treatment cases of cancer. Modern technologies of genomic and postgenomic studies, as well as molecular imaging methods (positron and single photon emission computed tomography, PET and SPECT, respectively) make it possible not only to assess the metabolic and receptor status of tumor foci, but also to select the optimal therapeutic tactics as a key to the lock. In the clinical practice of oncology, there is an increasing need for molecular tumor board (MTB). Published real clinical experience with MTB-recommended treatment regimens based on the molecular geno-transcriptomic profile of the tumor indicates better relapse-free and overall patient survival compared to treatment prescribed by a physician without taking into account the molecular profile of the tumor. More experience is needed and randomized controlled clinical trials are needed for more solid and evidence-based conclusions. However, there is no doubt that the MTB is a powerful tool for the development of precision personalized oncology.

摘要

临床肿瘤学目前正经历着前所未有的变革时期。靶向治疗以及随后的免疫治疗,已经彻底改变了许多实体癌患者的临床病程和治疗结果。临床肿瘤学与分子肿瘤学密不可分,分子肿瘤学的发展相互关联。分子肿瘤研究提出制定最精确、有效且毒性较小的抗肿瘤治疗方案是一项极其紧迫的临床任务,尤其是在癌症危及生命且对其他类型治疗耐药的情况下。基因组和后基因组研究的现代技术,以及分子成像方法(分别为正电子发射断层扫描和单光子发射计算机断层扫描,即PET和SPECT)不仅能够评估肿瘤病灶的代谢和受体状态,还能选择最佳治疗策略,就像一把钥匙开一把锁。在肿瘤学临床实践中,对分子肿瘤委员会(MTB)的需求日益增加。已发表的基于肿瘤分子基因转录组谱的MTB推荐治疗方案的实际临床经验表明,与医生未考虑肿瘤分子谱而开出的治疗方案相比,患者的无复发生存期和总生存期更好。需要更多经验,也需要进行随机对照临床试验以得出更可靠和有循证依据的结论。然而,毫无疑问,MTB是精准个性化肿瘤学发展的有力工具。

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本文引用的文献

1
Rational combinations of targeted cancer therapies: background, advances and challenges.靶向癌症治疗的合理组合:背景、进展与挑战
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The molecular tumor board: a tool for the governance of precision oncology in the real world.分子肿瘤委员会:真实世界中精准肿瘤学治理的工具。
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The challenge of the Molecular Tumor Board empowerment in clinical oncology practice: A Position Paper on behalf of the AIOM- SIAPEC/IAP-SIBioC-SIC-SIF-SIGU-SIRM Italian Scientific Societies.分子肿瘤委员会在临床肿瘤学实践中的赋权挑战:代表 AIOM-SIAPEC/IAP-SIBioC-SIC-SIF-SIGU-SIRM 意大利科学学会的立场文件。
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JCO Precis Oncol. 2021 Jul 9;5. doi: 10.1200/PO.20.00495. eCollection 2021 Jul.
9
Framework for Implementing and Tracking a Molecular Tumor Board at a National Cancer Institute-Designated Comprehensive Cancer Center.国家癌症研究所指定综合癌症中心实施和跟踪分子肿瘤委员会的框架。
Oncologist. 2021 Nov;26(11):e1962-e1970. doi: 10.1002/onco.13936. Epub 2021 Sep 8.
10
The molecular profiling of solid tumors by liquid biopsy: a position paper of the AIOM-SIAPEC-IAP-SIBioC-SIC-SIF Italian Scientific Societies.液体活检对实体瘤的分子谱分析:意大利肿瘤学会-意大利临床肿瘤学会-意大利生物标志物学会-意大利放射肿瘤学会-意大利核医学学会-意大利胸科医师学会的联合立场文件。
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