Non-invasive approaches to monitor EGFR-TKI treatment in non-small-cell lung cancer.
Non-invasive approaches to monitor EGFR-TKI treatment in non-small-cell lung cancer.
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DOI：
10.1186/s13045-015-0193-6
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发表时间：
2015-07-31
影响因子：
28.5
通讯作者：
Wu K
中科院分区：
文献类型：
--
作者：
Sun W;Yuan X;Tian Y;Wu H;Xu H;Hu G;Wu K
表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKI）是携带活化表皮生长因子受体（EGFR）突变的晚期非小细胞肺癌（NSCLC）患者的标准治疗。目前，EGFR突变分析的常规材料是手术或活检获得的肿瘤组织。然而，在晚期NSCLC中，肿瘤组织的可及性并不总是令人满意。此外，高比例的NSCLC患者最终会对EGFR-TKI产生耐药性。反复进行侵入性手术（如手术或活检）以评估EGFR-TKI耐药性的演变是不切实际的。因此，迫切需要探索一些方便、微创的技术来监测EGFR-TKI治疗。循环无细胞肿瘤DNA（ctDNA）对检测NSCLC中的EGFR突变具有高度特异性。此外，ctDNA能够在EGFR-TKI治疗期间监测疾病进展。某些与EGFR信号通路相关的血清microRNA，如miR-21和miR-10 b，已被证明有助于评估EGFR-TKI治疗的有效性。一种商业化的基于血清的蛋白质组学检测（称为VeriStrat检测）已显示出预测接受EGFR-TKI治疗的NSCLC患者的临床结局的出色能力。分析循环肿瘤细胞（CTC）中的EGFR突变是可行的，CTC代表了预测EGFR-TKI治疗疗效和耐药性的有前景的材料。这些证据表明，基于血清或血浆样本的非侵入性技术在监测NSCLC中的EGFR-TKI治疗方面具有很大的潜力。在这篇综述中，我们总结了这些非侵入性方法，并考虑了它们在EGFR-TKI治疗监测中的可能应用。
Tyrosine kinase inhibitors of epidermal growth factor receptor (EGFR-TKIs) are standard treatments for advanced non-small-cell lung cancer (NSCLC) patients harboring activating epidermal growth factor receptor (EGFR) mutations. Nowadays, tumor tissues acquired by surgery or biopsy are the routine materials for EGFR mutation analysis. However, the accessibility of tumor tissues is not always satisfactory in advanced NSCLC. Moreover, a high proportion of NSCLC patients will eventually develop resistance to EGFR-TKIs. Invasive procedures, such as surgery or biopsy, are impractical to be performed repeatedly to assess the evolution of EGFR-TKI resistance. Thus, exploring some convenient and less invasive techniques to monitor EGFR-TKI treatment is urgently needed. Circulating cell-free tumor DNA (ctDNA) has a high degree of specificity to detect EGFR mutations in NSCLC. Besides, ctDNA is capable of monitoring the disease progression during EGFR-TKI treatment. Certain serum microRNAs that correlate with EGFR signaling pathway, such as miR-21 and miR-10b, have been demonstrated to be helpful in evaluating the efficiency of EGFR-TKI therapeutics. A commercialized serum-based proteomic test, named VeriStrat test, has shown an outstanding ability to predict the clinical outcome of NSCLC patients receiving EGFR-TKIs. Analysis of EGFR mutations in circulating tumor cells (CTCs) is feasible, and CTCs represent a promising material to predict EGFR-TKI-treatment efficacy and resistance. These evidences suggested that non-invasive techniques based on serum or plasma samples had a great potential for monitoring EGFR-TKI treatment in NSCLC. In this review, we summarized these non-invasive approaches and considered their possible applications in EGFR-TKI-treatment monitoring.