Padinharayil Hafiza, Varghese Jinsu, John Mithun Chacko, Rajanikant Golgodu Krishnamurthy, Wilson Cornelia M, Al-Yozbaki Minnatallah, Renu Kaviyarasi, Dewanjee Saikat, Sanyal Rupa, Dey Abhijit, Mukherjee Anirban Goutam, Wanjari Uddesh Ramesh, Gopalakrishnan Abilash Valsala, George Alex
Jubilee Centre for Medical Research, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala 680005, India.
PG & Research Department of Zoology, St. Thomas College, Kozhenchery, Pathanamthitta, Kerala 689641, India.
Genes Dis. 2022 Aug 23;10(3):960-989. doi: 10.1016/j.gendis.2022.07.023. eCollection 2023 May.
Continuous revision of the histologic and stage-wise classification of lung cancer by the World Health Organization (WHO) provides the foundation for therapeutic advances by promoting molecular targeted and immunotherapies and ensuring accurate diagnosis. Cancer epidemiologic data provide helpful information for cancer prevention, diagnosis, and management, supporting health-care interventions. Global cancer mortality projections from 2016 to 2060 show that cancer will overtake ischemic heart diseases (IHD) as the leading cause of death (18.9 million) immediately after 2030, surpassing non-small cell lung cancer (NSCLC), which accounts for 85 percent of lung cancers. The clinical stage at the diagnosis is the main prognostic factor in NSCLC therapies. Advanced early diagnostic methods are essential as the initial stages of cancer show reduced mortality compared to the advanced stages. Sophisticated approaches to proper histological classification and NSCLC management have improved clinical efficiency. Although immune checkpoint inhibitors (ICIs) and targeted molecular therapies have refined the therapeutic management of late-stage NSCLC, the specificity and sensitivity of cancer biomarkers should be improved by focusing on prospective studies, followed by their use as therapeutic tools. The liquid biopsy candidates such as circulating tumor cells (CTCs), circulating cell-free tumor DNA (cfDNA), tumor educated platelets (TEP), and extracellular vesicles (EVs) possess cancer-derived biomolecules and aid in tracing: driver mutations leading to cancer, acquired resistance caused by various generations of therapeutic agents, refractory disease, prognosis, and surveillance.
世界卫生组织(WHO)对肺癌组织学和分期分类的持续修订,通过推动分子靶向治疗和免疫治疗并确保准确诊断,为治疗进展奠定了基础。癌症流行病学数据为癌症预防、诊断和管理提供了有用信息,支持医疗保健干预措施。2016年至2060年的全球癌症死亡率预测表明,癌症将在2030年后立即超过缺血性心脏病(IHD),成为主要死因(1890万),超过占肺癌85%的非小细胞肺癌(NSCLC)。诊断时的临床分期是非小细胞肺癌治疗的主要预后因素。先进的早期诊断方法至关重要,因为癌症早期阶段的死亡率与晚期相比有所降低。恰当的组织学分类和非小细胞肺癌管理的复杂方法提高了临床效率。尽管免疫检查点抑制剂(ICIs)和靶向分子疗法改善了晚期非小细胞肺癌的治疗管理,但应通过关注前瞻性研究来提高癌症生物标志物的特异性和敏感性,随后将其用作治疗工具。循环肿瘤细胞(CTCs)、循环游离肿瘤DNA(cfDNA)、肿瘤衍生血小板(TEP)和细胞外囊泡(EVs)等液体活检候选物含有癌症衍生的生物分子,有助于追踪:导致癌症的驱动突变、各代治疗药物引起的获得性耐药、难治性疾病、预后和监测。