Adaptive lung cancer therapy:future perspectives
10.12354/j.issn.1000-8179.2024.20240641
- VernacularTitle:肺癌适应性治疗:未来研究方向
- Author:
Zheng MEIMEI
1
;
Gan BIN
;
Wu YILONG
Author Information
1. 广东省心血管病研究所,广东省人民医院,广东省医学科学院(广州市 510080);广东省肺癌研究所,南方医科大学附属广东省人民医院(广东省医学科学院)
- Keywords:
non-small cell lung cancer(NSCLC);
adaptive therapy;
de-escalation therapy;
biomarker
- From:
Chinese Journal of Clinical Oncology
2024;51(16):811-816
- CountryChina
- Language:Chinese
-
Abstract:
In the era of precision medicine,patients with lung cancer receive molecular subtype-based personalized management.The un-met clinical need initiated the concept of adaptive therapy,a novel personalized treatment strategy referring to the biomarker-directed treatment escalation or de-escalation based on the standard of care,aiming to improve efficacy,quality of life,and cost efficiency.Biomark-ers are validated under specific clinical scenarios to dynamically and stably predict disease-free status or efficacy.The optimal clinical scen-arios for adaptive therapy comprises post-treatment and radiologically lesion-free or metabolically inactive disease status.Several promising clinical situations are exploring de-escalation therapy,including epidermal growth factor receptor(EGFR)-mutated,totally resected non-small cell lung cancer(NSCLC),driver gene-negative,totally resected NSCLC,driver gene-negative,radiochemotherapy-treated,locally advanced NSCLC,and drug holidays for metastatic NSCLC.Therefore,circulating tumor DNA-minimal residual disease,(ctDNA-MRD)is considered an important biomarker.Concerning escalation therapy,this field is less well-supported with results,demanding further exploration.Related to future perspectives,more effort should be invested in focusing on patients with unmet clinical needs,even those with a standard of care,and providing biomarker-based adaptive therapy for efficacy and efficiency improvement.
