Dipartimento di Medicina Sperimentale (DIMES), Università Degli Studi di Genova, Via Leon Battista Alberti 2, 16132 Genova, Italy.
Departement de Medicine Oncologique, Institut Gustave Roussy, 114 Rue Edouard Vaillant, 94800 Villejuif, France.
Int J Mol Sci. 2023 Dec 22;25(1):224. doi: 10.3390/ijms25010224.
Small cell lung cancer (SCLC) has been historically considered a homogeneous disease and thus approached as a single entity when it comes to clinical studies design and new treatments developments. However, increasing knowledge in the genetic and molecular landscape of this disease challenges this concept, opening the possibility that different subtypes might show differential vulnerability to treatments. In this narrative review, we gather the most relevant advances in genetic and molecular characterization of SCLC, focusing on how these discoveries may be used to design the path for a personalized treatment approach. Indeed, we discuss the new classification based on differential protein expression, the prevalence and significance of oncogenic drivers (e.g., mutations and rearrangements) in SCLC, the genetic characteristics of SCLC in patients with no smoking history, and the existing evidence supporting the use of liquid biopsy for capturing the heterogeneity of the disease. We use the keywords "small cell lung cancer", "SCLC", "EGFR", "ALK", "histological transformation", and "transcriptional factors" to identify original research manuscripts, clinical trials, case reports, and case series from PubMed.
小细胞肺癌 (SCLC) 一直被认为是一种同质疾病，因此在临床研究设计和新治疗方法的开发方面被视为单一实体。然而，随着对这种疾病的遗传和分子特征的深入了解，这一概念受到了挑战，不同亚型可能对治疗有不同的敏感性成为可能。在这篇叙述性综述中，我们收集了 SCLC 遗传和分子特征方面的最相关进展，重点讨论了这些发现如何用于设计个性化治疗方法的途径。事实上，我们讨论了基于差异蛋白表达的新分类，SCLC 中致癌驱动因素（如 EGFR 突变和 ALK 重排）的流行程度和意义，无吸烟史患者的 SCLC 的遗传特征，以及支持使用液体活检来捕捉疾病异质性的现有证据。我们使用关键词“small cell lung cancer”、“SCLC”、“EGFR”、“ALK”、“组织学转化”和“转录因子”从 PubMed 中识别原始研究手稿、临床试验、病例报告和病例系列。
