Diagnosing and assisting precision treatment: opening up new directions for treatment
A few days ago, the media accompanying diagnosis and assisting lung cancer precision treatment will be held in Xiamen. Professor Cui Tongjian, director of the Department of Oncology, Fujian Provincial Hospital, said at the meeting that the incidence and mortality rate of lung cancer in China continued to be the highest, with an annual increase of about 730,000 new cases of lung cancer, which seriously endangered people's health. As the mutations of unique genes in different cancers are continuously discovered and the clinical application of targeted drug therapy for these mutant genes, the accompanying diagnosis can help clinicians find patients with these genetic mutations, improving the efficacy and safety of targeted drugs. It plays a huge role in reducing sex and reducing medical costs, and is the key to achieving accurate cancer treatment .
Professor Cui Tongjian, Director of Department of Oncology, Fujian Provincial Hospital, delivered a speech
Concomitant diagnosis targeted therapy = precision medicine
Due to the existence of individual genetic differences, the treatments for cancer and their effects vary from person to person. The traditional treatment strategy of “the same disease, the same treatment plan†can no longer meet the treatment needs of patients, and individualized medical treatment has become the trend of the times. As the main means of individualized medical treatment, "targeted therapy" mainly kills malignant tumor cells in a targeted manner through the selection of genes or molecules, and hardly affects normal cells, and has the characteristics of "high efficiency and low toxicity". As an in vitro diagnostic technology associated with targeted drugs, "concomitant diagnosis" mainly selects the best drug users in different types of disease populations by detecting the expression levels of proteins and mutant genes in humans. Conduct personalized medicine. With the close cooperation between the diagnostic and pharmaceutical fields in terms of expertise and technology, concomitant diagnosis and targeted therapy have become the two most important tools for achieving precision medicine.
Professor Zhang Jie, Director of Pathology, Shanghai Chest Hospital
Professor Zhang Jie, director of the Department of Pathology, Shanghai Chest Hospital, pointed out: "We have entered the era of personalized medicine, and accompanying diagnosis plays an indispensable role in providing important guidance and treatment information for the promotion of personalized medicine. Accurate concomitant diagnosis The results provide a strong basis for the clinical selection of appropriate targeted drugs, helping patients to tailor the optimal treatment regimen, making it possible for patients to achieve maximum survival benefits."
First detection and treatment
Lung cancer is generally divided into small cell lung cancer and non-small cell lung cancer, of which non-small cell lung cancer stations are more than 80%, and mainly include lung adenocarcinoma and lung squamous cell carcinoma. About 70% of patients with non-small cell lung cancer are diagnosed at an advanced stage and are not sensitive to chemoradiotherapy, resulting in high mortality and a five-year survival rate of only 15%. In Asian patients with lung adenocarcinoma, 87% of patients were found to have known driver genes, 81% of which have a targeted targeting inhibitor, and 66% of patients can receive individualized targeted therapy for marketed drugs. .
Gradual lymphoma kinase (ALK) and epidermal growth factor receptor (EGFR) gene mutant lung cancer are lung cancer types with well-defined molecular targets, target detection techniques, and market-targeted drugs. Among them, ALK fusion gene mainly occurs in lung cancer patients who do not smoke or smoke less, accounting for 5% of all non-small cell lung cancer. The number of new cases in China is about 35,000 per year. Such patients can usually be from ALK inhibitors (Crizocin). Ni) benefit from targeted drug therapy. Studies have shown that patients with ALK-positive non-small cell lung cancer receive a 5-year survival rate of 55% with crizotinib monotherapy, while chemotherapy survival rate is only 12%.
EGFR is a "high-frequency" driving gene for non-small cell lung cancer. The proportion of EGFR-sensitive mutations in Asian populations is 30% to 40%, which is much higher than in European and American countries. Currently, EGFR inhibitors (erlotinib) are targeted therapies that prolong the survival of patients with EGFR-positive non-small cell lung cancer, and their tolerance and quality of life are higher than traditional chemotherapy. Clinical studies published in 2012 showed that patients who had undergone mutations in the cobasEGFR gene mutation and who were treated with erlotinib would have an average progression-free survival of patients treated with erlotinib compared with patients treated with chemotherapy as first-line therapy. It was 4.3 months.
In this regard, Professor Cui Tongjian pointed out that for lung cancer patients with positive mutations, targeted therapy is undoubtedly a better choice. Targeted therapy for ALK and EGFR-positive patients is superior to traditional chemotherapy and can significantly prolong patient survival. Therefore, accurate identification of patients with ALK and EGFR-positive non-small cell lung cancer plays a decisive role in the selection of targeted therapy planning. First detection, post-treatment, and targeted therapy with accompanying diagnosis are the best solutions for the diagnosis and treatment of lung cancer.
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