Núcleo de Genética Humana e Molecular, Centro de Ciências Humanas e Naturais, Departamento de Ciências Biológicas, Universidade Federal do Espírito Santo (UFES), Vitória 29075-910, Brazil.
Centro de Ciências da Saúde, Curso de Medicina, Universidade Federal do Espírito Santo (UFES), Vitória 29090-040, Brazil.
Genes (Basel). 2023 Oct 4;14(10):1906. doi: 10.3390/genes14101906.
Lung cancer is a highly aggressive neoplasm and, despite the development of recent therapies, tumor progression and recurrence following the initial response remains unsolved. Several questions remain unanswered about non-small cell lung cancer (NSCLC): (1) Which patients will actually benefit from therapy? (2) What are the predictive factors of response to MAbs and TKIs? (3) What are the best combination strategies with conventional treatments or new antineoplastic drugs? To answer these questions, an integrative literature review was carried out, searching articles in PUBMED, NCBI-PMC, Google Academic, and others. Here, we will examine the molecular genetics of lung cancer, emphasizing NSCLC, and delineate the primary categories of inhibitors based on their molecular targets, alongside the main treatment alternatives depending on the type of acquired resistance. We highlighted new therapies based on epigenetic information and a single-cell approach as a potential source of new biomarkers. The current and future of NSCLC management hinges upon genotyping correct prognostic markers, as well as on the evolution of precision medicine, which guarantees a tailored drug combination with precise targeting.
肺癌是一种高度侵袭性的肿瘤，尽管最近有了新的治疗方法，但初始反应后肿瘤的进展和复发仍然没有得到解决。关于非小细胞肺癌（NSCLC）还有几个问题尚未得到解答：（1）哪些患者实际上会从治疗中受益？（2）Mabs 和 TKIs 反应的预测因素是什么？（3）与传统治疗或新型抗肿瘤药物联合的最佳策略是什么？为了回答这些问题，我们进行了综合文献回顾，在 PUBMED、NCBI-PMC、Google Scholar 等数据库中搜索文章。在这里，我们将研究肺癌的分子遗传学，重点关注 NSCLC，并根据其分子靶点对主要抑制剂类别进行描述，同时根据获得性耐药的类型概述主要的治疗选择。我们强调了基于表观遗传学信息和单细胞方法的新疗法，这可能是新生物标志物的来源。NSCLC 管理的现在和未来取决于正确的预后标志物的基因分型，以及精准医学的发展，这保证了药物的精准靶向联合。
