ABSTRACT

Introduction

Non-small cell lung cancer (NSCLC) comprises of 84% of all lung cancer cases. The treatment options for NSCLC at advanced stages are chemotherapy and radiotherapy. Chemotherapy involves conventional nonspecific chemotherapeutics, and targeted-protein/receptor-specific small molecule inhibitors. Biologically targeted therapies such as an antibody-based immunotherapy have been approved in combination with conventional therapeutics. Approved targeted chemotherapy is directed against the kinase domains of mutated cellular receptors such as epidermal growth factor receptor (EGFR), anaplastic lymphoma kinases (ALK), neurotrophic receptor kinases (NTRK) and against downstream signaling molecules such as BRAF (v-raf murine sarcoma viral oncogene homolog B1). Approved biologically targeted therapy involves the use of anti-angiogenesis antibodies and antibodies against immune checkpoints.

Areas covered

The rationale for the employment of targeted therapeutics and the resistance that may develop to therapy are discussed. Novel targeted therapeutics in clinical trials are also included.

Expert opinion

Molecular and histological profiling of a given tumor specimen to determine the aberrant onco-driver is a must before deciding a targeted therapeutic regimen for the patient. Periodic monitoring of the patients response to a given therapeutic regimen is also mandatory so that any semblance of resistance to therapy can be deciphered and the regimen may be accordingly altered.

中文翻译：

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非小细胞肺癌的靶向药物治疗：临床意义和可能的解决方案-第一部分。

摘要

介绍

非小细胞肺癌（NSCLC）占所有肺癌病例的84％。晚期NSCLC的治疗选择是化学疗法和放射疗法。化学疗法涉及常规的非特异性化学疗法和靶向蛋白/受体特异性小分子抑制剂。生物靶向疗法，例如基于抗体的免疫疗法，已经被批准与常规疗法结合使用。批准的靶向化疗针对突变的细胞受体（如表皮生长因子受体（EGFR），间变性淋巴瘤激酶（ALK），神经营养受体激酶（NTRK））的激酶结构域以及下游信号分子（如BRAF（v-raf鼠肉瘤）病毒癌基因同源物B1）。

覆盖区域

讨论了使用靶向疗法的基本原理以及对疗法可能产生的耐药性。还包括临床试验中的新型靶向疗法。

专家意见

在确定患者的靶向治疗方案之前，必须对给定的肿瘤标本进行分子和组织学分析，以确定异常的促癌驱动因子。定期监视患者对给定治疗方案的反应也是强制性的，以便可以解密出对治疗耐药性的任何表象，并可以相应地改变治疗方案。