ABSTRACT

Introduction: The treatment scenario of lung cancer is rapidly evolving through time. In parallel, growing evidence is accumulating on different mechanisms of treatment resistance. Inter- and intra-tumor heterogeneity define the spatial and temporal tumor clonal evolution, that is at the basis of tumor progression and resistance to anticancer treatments.

Areas covered: This review summarizes the available evidence on molecular heterogeneity in lung cancer, from diagnosis to the occurrence of treatment resistance. The application of novel molecular diagnostic methods to detect molecular heterogeneity, and the implications of understanding heterogeneity for drug development strategies are discussed, with focus on clinical relevance and impact on patients’ survival.

Expert opinion: The current knowledge of molecular heterogeneity allows to identify different molecular subgroups of patients within the same conventional tumor type. Deeper understanding of heterogeneity determinants and the possibility to comprehensively investigate tumor molecular patterns will lead to the development of personalized treatment approaches, with the final goal to overcome resistance and prolong survival in lung cancer patients.

摘要

简介：肺癌的治疗方案随着时间的推移而迅速发展。与此同时，越来越多的证据表明治疗耐药的不同机制。肿瘤间和肿瘤内异质性定义了空间和时间肿瘤克隆进化，这是肿瘤进展和抗癌治疗耐药性的基础。

涵盖的领域：本综述总结了肺癌分子异质性的现有证据，从诊断到治疗耐药的发生。讨论了新的分子诊断方法在检测分子异质性中的应用，以及理解异质性对药物开发策略的影响，重点关注临床相关性和对患者生存的影响。

专家意见：目前关于分子异质性的知识允许在相同的常规肿瘤类型中识别患者的不同分子亚组。对异质性决定因素的更深入了解以及全面研究肿瘤分子模式的可能性将导致个性化治疗方法的发展，最终目标是克服肺癌患者的耐药性并延长生存期。