Non-small-cell lung cancer
Non-small-cell lung cancer
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DOI：
10.1038/nrdp.2015.9
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发表时间：
2015-05-21
影响因子：
81.5
通讯作者：
Rosell, Rafael
中科院分区：
文献类型：
--
作者：
Gridelli, Cesare;Rossi, Antonio;Rosell, Rafael
肺癌是最常见的癌症之一，也是全球癌症相关死亡的主要原因。非小细胞肺癌(NSCLC)是一种异质性肿瘤，约占所有新诊断肺癌的85%。吸烟仍然是患上这种疾病的主要风险因素，但氡暴露和空气污染也起到了一定作用。由于筛查计划不足和临床症状出现较晚，大多数患者被诊断为晚期疾病；因此，患者的预后非常差。非小细胞肺癌可以采用几种诊断方法，包括X光、CT和PET成像，以及肿瘤活检的组织学检查。需要对癌症进行准确的分期，以确定最佳的治疗策略，其中包括手术、放射化疗、免疫治疗，以及如果肿瘤存在癌基因突变，则使用抗血管生成单抗或酪氨酸激酶抑制剂的靶向治疗。其中几个驱动因素的突变已经被发现(例如，在表皮生长因子受体(EGFR)和间变性淋巴瘤激酶(ALK)中)，治疗继续前进，以解决获得性耐药问题。此外，姑息治疗在患者管理中发挥着核心作用，并极大地提高了生活质量。有关本初级读本的图解摘要，请访问：http://go.nature.com/rWYFgg
Lung cancer is one of the most frequently diagnosed cancers and is the leading cause of cancer-related death worldwide. Non-small-cell lung cancer (NSCLC), a heterogeneous class of tumours, represents approximately 85% of all new lung cancer diagnoses. Tobacco smoking remains the main risk factor for developing this disease, but radon exposure and air pollution also have a role. Most patients are diagnosed with advanced-stage disease owing to inadequate screening programmes and late onset of clinical symptoms; consequently, patients have a very poor prognosis. Several diagnostic approaches can be used for NSCLC, including X-ray, CT and PET imaging, and histological examination of tumour biopsies. Accurate staging of the cancer is required to determine the optimal management strategy, which includes surgery, radiochemotherapy, immunotherapy and targeted approaches with anti-angiogenic monoclonal antibodies or tyrosine kinase inhibitors if tumours harbour oncogene mutations. Several of these driver mutations have been identified (for example, in epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK)), and therapy continues to advance to tackle acquired resistance problems. Also, palliative care has a central role in patient management and greatly improves quality of life. For an illustrated summary of this Primer, visit: http://go.nature.com/rWYFgg