Challenges in molecular testing in non-small-cell lung cancer patients with advanced disease
Challenges in molecular testing in non-small-cell lung cancer patients with advanced disease
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DOI：
10.1016/s0140-6736(16)31340-x
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发表时间：
2016-09-03
期刊：
影响因子：
168.9
通讯作者：
Swanton, Charles
中科院分区：
文献类型：
--
作者：
Hiley, Crispin T.;Le Quesne, John;Swanton, Charles
肺癌诊断在过去十年中取得了很大进展。开发分子检测以使用通过微创技术获得的较小样本来识别越来越多的潜在临床可操作的遗传变异是一个巨大的挑战。肿瘤异质性和癌症对治疗的反应意味着重复活检或循环生物标志物可能越来越有用，以适应耐药性发展的治疗。我们强调了EGFR、ALK和新生物标志物（如PDL 1）的分子检测在临床实践中面临的一些挑战。用于非小细胞肺癌分子诊断的下一代测序平台的实施越来越普遍，允许从单个样本中检测多种遗传变异。在英国分层医学计划和英国国家肺基质试验的背景下讨论了使用下一代测序招募分子分层临床试验。
Lung cancer diagnostics have progressed greatly in the previous decade. Development of molecular testing to identify an increasing number of potentially clinically actionable genetic variants, using smaller samples obtained via minimally invasive techniques, is a huge challenge. Tumour heterogeneity and cancer evolution in response to therapy means that repeat biopsies or circulating biomarkers are likely to be increasingly useful to adapt treatment as resistance develops. We highlight some of the current challenges faced in clinical practice for molecular testing of EGFR, ALK, and new biomarkers such as PDL1. Implementation of next generation sequencing platforms for molecular diagnostics in non-small-cell lung cancer is increasingly common, allowing testing of multiple genetic variants from a single sample. The use of next generation sequencing to recruit for molecularly stratified clinical trials is discussed in the context of the UK Stratified Medicine Programme and The UK National Lung Matrix Trial.