Small cell lung cancer: where do we go from here?
Small cell lung cancer: where do we go from here?
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DOI：
10.1002/cncr.29098
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发表时间：
2015-03-01
期刊：
影响因子：
6.2
通讯作者：
Rudin CM
中科院分区：
文献类型：
--
作者：
Byers LA;Rudin CM
小细胞肺癌（SCLC）是一种侵袭性疾病，约占所有肺癌的14%。在美国，每年约有31，000名患者被诊断患有SCLC。尽管有许多临床试验，包括自20世纪70年代以来的至少40项III期试验，但SCLC患者的全身治疗在过去几十年中没有发生显著变化。因此，5年生存率仍然很低，总体<7%，大多数患者在诊断后仅存活1年或更短时间。与非小细胞肺癌（NSCLC）不同，其中使用靶向治疗已经取得了重大进展，仍然没有批准用于SCLC的靶向药物。SCLC进展的重大障碍包括1）缺乏早期检测模式，2）由于诊断性活检较小以及标准治疗中很少使用手术切除，因此用于转化研究（例如，DNA、RNA和/或蛋白质改变的分子谱分析）的肿瘤组织有限，以及3）疾病进展迅速，对导致治疗耐药性的机制了解不足。在本报告中，作者回顾了SCLC治疗的现状、当前对基础疾病生物学了解的最新进展，以及推进SCLC患者转化研究和治疗方法的机会。
Small cell lung cancer (SCLC) is an aggressive disease that accounts for approximately 14% of all lung cancers. In the United States, approximately 31,000 patients are diagnosed annually with SCLC. Despite numerous clinical trials, including at least 40 phase 3 trials since the 1970s, systemic treatment for patients with SCLC has not changed significantly in the past several decades. Consequently, the 5-year survival rate remains low at <7% overall, and most patients survive for only 1 year or less after diagnosis. Unlike nonsmall cell lung cancer (NSCLC), in which major advances have been made using targeted therapies, there are still no approved targeted drugs for SCLC. Significant barriers to progress in SCLC include 1) a lack of early detection modalities, 2) limited tumor tissue for translational research (eg, molecular profiling of DNA, RNA, and/or protein alterations) because of small diagnostic biopsies and the rare use of surgical resection in standard treatment, and 3) rapid disease progression with poor understanding of the mechanisms contributing to therapeutic resistance. In this report, the authors review the current state of SCLC treatment, recent advances in current understanding of the underlying disease biology, and opportunities to advance translational research and therapeutic approaches for patients with SCLC.