Personalized targeted therapy for lung cancer.
Personalized targeted therapy for lung cancer.
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DOI：
10.3390/ijms130911471
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发表时间：
2012
影响因子：
5.6
通讯作者：
Cho WCS
中科院分区：
文献类型：
--
作者：
Wu K;House L;Liu W;Cho WCS
长期以来，肺癌一直被认为是一种极其异质的疾病，因为每位患者的临床特征、预后、治疗反应和耐受性都是独一无二的。个性化医疗是指使用标记来预测哪些患者最有可能从治疗中受益。在肺癌中，发育良好的表皮生长因子受体（EGFR）和新出现的EML4-间变性淋巴瘤激酶（ALK）是重要的治疗靶点。本综述涵盖了 EGFR 和 EML4-ALK 激活的基本机制、预测生物标志物、耐药机制以及当前的靶向酪氨酸激酶抑制剂。本综述将通过总结在基于生物标志物的选定患者中进行的前瞻性临床试验来讨论 EGFR 和 ALK 靶向治疗的疗效。此外，革命性的测序和系统策略也将包含在本次综述中，因为这些技术将提供对癌症分子特征的全面了解，允许更好地对患者进行分层，以获得最合适的靶向治疗，最终产生更有前景的个性化治疗。非亚洲患者中 EGFR 和 ALK 的发生率相对较低，且突变患者缺乏反应，限制了针对 EGFR 或 ALK 的治疗的应用。尽管如此，可以预见的是，测序和系统策略可能为这些患者提供解决方案。
Lung cancer has long been recognized as an extremely heterogeneous disease, since its development is unique in every patient in terms of clinical characterizations, prognosis, response and tolerance to treatment. Personalized medicine refers to the use of markers to predict which patient will most likely benefit from a treatment. In lung cancer, the well-developed epidermal growth factor receptor (EGFR) and the newly emerging EML4-anaplastic lymphoma kinase (ALK) are important therapeutic targets. This review covers the basic mechanism of EGFR and EML4-ALK activation, the predictive biomarkers, the mechanism of resistance, and the current targeted tyrosine kinase inhibitors. The efficacy of EGFR and ALK targeted therapies will be discussed in this review by summarizing the prospective clinical trials, which were performed in biomarker-based selected patients. In addition, the revolutionary sequencing and systems strategies will also be included in this review since these technologies will provide a comprehensive understanding in the molecular characterization of cancer, allow better stratification of patients for the most appropriate targeted therapies, eventually resulting in a more promising personalized treatment. The relatively low incidence of EGFR and ALK in non-Asian patients and the lack of response in mutant patients limit the application of the therapies targeting EGFR or ALK. Nevertheless, it is foreseeable that the sequencing and systems strategies may offer a solution for those patients.
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影响因子：
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作者：
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通讯作者：
Chirieac, Lucian R.
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