Rumyantsev P O
MMC Group of clinics.
Probl Endokrinol (Mosk). 2023 Jan 9;68(6):5-11. doi: 10.14341/probl13220.
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.
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。