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个性化医疗:从分子视角看临床肿瘤学治疗。

Personalized medicine: Clinical oncology on molecular view of treatment.

作者信息

Da Silva Rafick Costa Dos Santos, Simon Nathalia de Andrade, Dos Santos André Alves, Olegário Gabriel De Melo, Da Silva Jayne Ferreira, Sousa Naide Oliveira, Corbacho Manuel Alvarez Troncoso, de Melo Fabrício Freire

机构信息

Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória Da Conquista 45029-094, Bahia, Brazil.

出版信息

World J Clin Oncol. 2024 Aug 24;15(8):992-1001. doi: 10.5306/wjco.v15.i8.992.

Abstract

Cancer, the second leading global cause of death, impacts both physically and emotionally. Conventional treatments such as surgeries, chemotherapy, and radiotherapy have adverse effects, driving the need for more precise approaches. Precision medicine enables more targeted treatments. Genetic mapping, alongside other molecular biology approaches, identifies specific genes, contributing to accurate prognoses. The review addresses, in clinical use, a molecular perspective on treatment. Biomarkers like alpha-fetoprotein, beta-human chorionic gonadotropin, 5-hydroxyindoleacetic acid, programmed death-1, and cytotoxic T lymphocyte-associated protein 4 are explored, providing valuable information. Bioinformatics, with an emphasis on artificial intelligence, revolutionizes the analysis of biological data, offering more accurate diagnoses. Techniques like liquid biopsy are emphasized for early detection. Precision medicine guides therapeutic strategies based on the molecular characteristics of the tumor, as evidenced in the molecular subtypes of breast cancer. Classifications allow personalized treatments, highlighting the role of trastuzumab and endocrine therapies. Despite the benefits, challenges persist, including high costs, tumor heterogeneity, and ethical issues. Overcoming obstacles requires collaboration, ensuring that advances in molecular biology translate into accessible benefits for all.

摘要

癌症是全球第二大致死原因,对身体和情绪都会产生影响。手术、化疗和放疗等传统治疗方法存在不良影响,这促使人们需要更精准的治疗方法。精准医学能够实现更具针对性的治疗。基因图谱以及其他分子生物学方法可识别特定基因,有助于做出准确的预后判断。本综述从临床应用角度探讨了治疗的分子视角。文中探讨了甲胎蛋白、β-人绒毛膜促性腺激素、5-羟吲哚乙酸、程序性死亡受体1和细胞毒性T淋巴细胞相关蛋白4等生物标志物,提供了有价值的信息。以人工智能为重点的生物信息学彻底改变了生物数据分析方式,能提供更准确的诊断。文中强调了液体活检等技术用于早期检测。精准医学根据肿瘤的分子特征指导治疗策略,乳腺癌的分子亚型就是例证。分类有助于实现个性化治疗,突出了曲妥珠单抗和内分泌疗法的作用。尽管有这些益处,但挑战依然存在,包括成本高昂、肿瘤异质性和伦理问题。克服这些障碍需要各方合作,确保分子生物学的进展能转化为让所有人都能受益的成果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6993/11346063/8aa1ccff9ed5/WJCO-15-992-g001.jpg

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