Global precision medicine welcomes the turn: opening a new era of cancer treatment
At present, precision medicine has opened a new era of cancer treatment. On a global scale, the medical profession is actively exploring and improving the precision medical ability, and has achieved considerable results in the field of lung cancer treatment, in the third generation of targeted therapy for non-small cell lung cancer. In the research of drugs, breakthroughs have been made internationally.
The incidence and mortality of lung cancer in China are high. There are about 730,000 new cases of lung cancer every year. About one-third of new lung cancer patients come from China every year, and EGFR gene mutant lung cancer is the most common.
vitality
It is gratifying to note that through the unremitting efforts of pharmaceutical companies and research institutions, breakthroughs have been made in the treatment of non-small cell lung cancer. The first and second generation of lung cancer targeted drugs have appeared, and they have entered the European and American countries. Clinical treatment, the effect is significant.
Since the first generation of lung cancer targeting drug gefitinib entered the Chinese market in 2005, China's non-small cell lung cancer treatment has also entered the era of targeted therapy. For more than a decade, the median survival of patients with advanced lung cancer has increased 2.4-fold, from the previous 14.1 months to 33.5 months.
Targeted therapy brings new hope to patients with advanced lung cancer, both in prolonging survival and improving quality of life. However, with the emergence of drug resistance, new problems have followed.
mutation
A targeted drug acts on a certain protein or a molecule of a cancer cell, so it only inhibits one pathway of tumor growth. When a pathway is inhibited, the tumor cells will seek new "living paths" and select other pathways to synthesize the substances needed for their own growth. Over time, the molecularly targeted drugs will be rendered useless, resulting in drug resistance. Studies have shown that 60% of patients with acquired resistance develop a second site mutation (T790M) in the epidermal growth factor receptor gene, that is, there are two mutation sites in the epidermal growth factor receptor gene.
According to Professor Wu Yilong, director of the Guangdong Provincial Institute of Lung Cancer and chairman of the Chinese Society of Clinical Oncology (CSCO), some patients with non-small cell lung cancer have mutations in the epidermal growth factor receptor gene, called EGFR mutations. After the first and second generation of EGFR inhibitors are targeted drugs, disease progression occurs after a relatively long period of validity (mostly 9 to 11 months). This condition is called acquired resistance.
Tumors develop resistance and existing treatments fail. In the absence of a new generation of targeted drugs, patients can only switch to chemotherapy. However, due to the lack of specificity of such treatment, the patient's non-deteriorating survival period is only about 6 months, and the side effects of treatment are large, and the quality of life of the patient is degraded.
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