Horvath Lilla, Lang Christian, Boettiger Kristiina, Aigner Clemens, Dome Balazs, Megyesfalvi Zsolt
National Koranyi Institute of Pulmonology, Budapest, Hungary.
Department of Thoracic Surgery, Comprehensive Cancer Center.
Curr Opin Oncol. 2024 Jan 1;36(1):51-56. doi: 10.1097/CCO.0000000000001005. Epub 2023 Oct 18.
Small cell lung cancer (SCLC) remains one of the most aggressive thoracic malignancies with an especially dismal prognosis. While the detection of various targetable driver mutations and immune checkpoints have revolutionized the treatment of non-small cell lung cancer (NSCLC), there has been only modest therapeutic innovation over the past decades in SCLC. In this review, we aim to provide a brief summary on the clinical relevance of recent research findings, which could soon pave the way towards a more personalized and targeted management of SCLC patients.
Substantial research on the biological and molecular heterogeneity of SCLC has been conducted in the last years. Recent results from comprehensive profiling studies have shown that unique major SCLC subtypes can be distinguished based on the relative expression of key transcription regulators (ASCL1, NEUROD1, POU2F3) or distinct inflammatory features. Understanding the differing molecular characteristics of these distinct subtypes has resulted in the identification of specific therapeutic vulnerabilities.
The recently introduced molecular SCLC subtype classification represents a substantial progress towards a personalized and more efficacious approach in SCLC. The consequences of this paradigm shift provide hope for improved patient care and clinical outcomes in this exceptionally lethal thoracic malignancy.
小细胞肺癌(SCLC)仍然是最具侵袭性的胸部恶性肿瘤之一,预后尤其不佳。虽然各种可靶向驱动突变和免疫检查点的发现彻底改变了非小细胞肺癌(NSCLC)的治疗,但在过去几十年里,SCLC的治疗创新却很有限。在本综述中,我们旨在简要总结近期研究结果的临床相关性,这些结果可能很快为SCLC患者更个性化和靶向治疗铺平道路。
近年来,对SCLC的生物学和分子异质性进行了大量研究。综合分析研究的最新结果表明,可根据关键转录调节因子(ASCL1、NEUROD1、POU2F3)的相对表达或不同的炎症特征区分独特的主要SCLC亚型。了解这些不同亚型的不同分子特征已导致确定特定的治疗弱点。
最近引入的分子SCLC亚型分类代表了在SCLC中实现个性化和更有效治疗方法的重大进展。这种范式转变的结果为改善这种极其致命的胸部恶性肿瘤的患者护理和临床结果带来了希望。