Advances in Treatment of Lung Cancer With Targeted Therapy
Advances in Treatment of Lung Cancer With Targeted Therapy
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DOI：
10.5858/arpa.2011-0618-ra
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发表时间：
2012-05-01
影响因子：
4.6
通讯作者：
Chirieac, Lucian R.
中科院分区：
文献类型：
--
作者：
Cagle, Philip T.;Chirieac, Lucian R.
背景。-正在进行的涉及新靶向治疗的临床前研究和临床试验有望提高肺癌患者的生存率。靶向治疗药物，基于肺癌中改变的基因突变和信号通路，显著增加了我们的肺癌治疗设备，同时最大限度地减少了药物毒性。迄今为止，美国食品和药物管理局已批准4种靶向治疗用于治疗肺癌：2002年的吉非替尼，2003年的厄洛替尼，2006年的贝伐单抗和2011年的克唑替尼。综述肺癌靶向治疗的分子生物学标志物、分子生物学基本原理、分子诊断技术以及与肺癌分子异常相关的病理学特征。回顾肺癌中描述的新的分子异常，这些异常预测了临床试验各个阶段中对新型有前途的靶向药物的反应。综述了肺癌分子异常的相关文献，重点介绍了肺癌的分子诊断和靶向治疗。特别强调的是总结不断发展的技术，在肺癌的诊断和表征有用。肺癌的分子检测扩展了病理学家的专业知识，病理学家将识别预测对各种靶向治疗的敏感性或耐药性的肿瘤标志物，并允许选择癌症患者进行高效且毒性较小的治疗。(Arch Pathol Lab Med. 2012;136：504-509; doi：10.5858/arpa.2011-0618-RA）
Context.-Ongoing preclinical investigations and clinical trials involving new targeted therapies promise to improve survival for patients with lung cancer. Targeted therapeutic agents, based on genetic mutations and signaling pathways altered in lung cancer, have added significantly to our armamentarium for lung cancer treatment while minimizing drug toxicity. To date, 4 targeted therapies have been approved for treatment of lung cancer by the US Food and Drug Administration: gefitinib in 2002, erlotinib in 2003, bevacizumab in 2006, and crizotinib in 2011.Objective.-To review targeted therapies in lung cancer, the molecular biomarkers that identify patients likely to benefit from these targeted therapies, the basic molecular biology principles, selected molecular diagnostic techniques, and pathologic features correlated with molecular abnormalities in lung cancer. To review new molecular abnormalities described in lung cancer that are predictive for response to novel promising targeted agents in various phases of clinical trials.Data Sources.-Review of the literature covering the molecular abnormalities of lung cancer with a focus on the molecular diagnostics and targeted therapy. Special emphasis is placed on summarizing evolving technologies useful in the diagnosis and characterization of lung cancer.Conclusions.-Molecular testing of lung cancer expands the expertise of the pathologist, who will identify the tumor markers that are predictive of sensitivity or resistance to various targeted therapies and allow patients with cancer to be selected for highly effective and less toxic therapies. (Arch Pathol Lab Med. 2012;136:504-509; doi: 10.5858/arpa.2011-0618-RA)