Now talking about the mere mention of cancer, especially lung cancer , it is like "death" of the call. But Shanghai's famous cancer expert Professor Lu Shun nothing and he said the new research by molecular targeted drugs "targeting" mutant gene, can prolong survival of patients with lung cancer three times. Lung cancer is no longer so terrible, but also treatable.
According to the latest cancer incidence survey data show that lung cancer has become the Shanghai residents account for morbidity and mortality in the first malignancy, Shanghai daily average of 129 new cases of cancer, of whom 23 are lung cancer. In male patients with lung cancer incidence rate of the first one, female lung cancer incidence in patients after breast cancer mortality also accounted for the first one. As the insidious onset of lung cancer, there is no typical symptoms early, 70% of patients in an advanced stage when the tumor was found, often the cancer has spread to other parts of the body. In this phase began receiving treatment, most patients only three months to one year survival is less than 5% of patients can survive for five years.
As a result, lung cancer is considered as the "death" of the call. Is it really no rule of law in the lung? Shanghai Chest Hospital Medical Center professor of primary lung tumors 任陆舜 said in the past, survival of patients with advanced lung cancer generally only nine months or so, but with the clinical application of targeted therapy drugs in the treatment of many poor late Patients have a new hope. For example, for carrying EGFR mutations in lung cancer patients, the use of gefitinib and erlotinib kind of molecular targeted therapy efficiency up to 70% -80%, a lot of late-targeted drug use patient has survived more than three years, and in the past only means of receiving chemotherapy compared to longer survival than tripled.
Take pesticides analogy, targeted therapy emphasizes "designed to kill cockroaches."
According to reports, in the field of cancer therapy, individual therapy has become a new trend, mainly because in-depth study of the molecular biology of the tumor, the tumor was found, there are some specific genetic changes, or special biological indicators, and these indicators if was used as a target to attack, not only targeted, but also changed in the past traditional chemotherapy, "rather victimizes, can not let go" model.
It is understood that targeted therapy has become a non -small cell lung cancer (80% -85% of the total lung cancer) treatment highlights. Lu Shun said, studies have shown that lung cancer is not to smoke there is usually a very important growth of the epidermal growth factor receptor gene. Mutations in this gene can cause lung cancer, or accelerate the progression of lung cancer. The targeted therapy can put this gene as a target for it to curb by inhibiting the growth of tumor cells. Take pesticides analogy, traditional chemotherapy can "kill a variety of pests," and emphasizes targeted therapy "designed to kill cockroaches", in other words, the latter is more targeted.
Lu Shun said that in the past the traditional chemotherapy often kills tumor cells but also normal cells in the body cause some damage, patients often can not tolerate the one hand, on the other hand, the complete remission rate and long-term survival results are still poor. So look for an effective and less toxic treatment for lung cancer research has been a hot spot in recent years.
Lu 舜介绍 said: "In the past a full 10 years for patients with advanced non-small cell lung cancer, we can only platinum-based two-drug regimen selection to choose, but no matter what the latest chemotherapy drugs, how to mix, mix. , the survival of these patients probably also in the nine months or so, often survive a year, but now many lung cancer patients have survived more than three years! "It also gives our country a lot of advanced lung cancer patients with a glimmer of hope. Research has shown that lung cancer patients in China, the epidermal growth factor receptor mutation rate of more than 30%, which is completely different in patients with the United States.
Lung cancer is also a chronic disease, patients can work as usual, life
Once, someone with "linger" to describe the survival of patients with advanced lung condition. However, with the progress of advanced lung cancer treatment, especially targeted therapy marketed drugs, cancer patients not only get longer survival, but also to live with greater dignity. "These patients may be at least a year and a half to two years to live a normal life, it's really hard to imagine in the past." Lu Shun said.
Due to the considerable side effects of chemotherapy, many patients a finished chemotherapy, the people seem no fine playing mining. Because frail, often vomiting , hair loss, patients usually only stay home, not go to work. But now, thanks to targeted therapy drugs have a good safety and tolerability profile compared to traditional chemotherapy, greatly reducing the side effects, the most common side effects are acne -like rash , diarrhea . These symptoms can be carried out by topical, oral medications, usually disappear after treatment, did not affect the patient's daily life. Lu Shun said, lung cancer can be a similar diabetes , hypertension and other chronic diseases. These patients are just like those with chronic lung patients, like remember to take medicine, can still work normally, daily life.
Furthermore, previous doctors encounter patients with advanced lung cancer, the first 4-6 cycles of chemotherapy will generally give priority to patients, after they suspended the treatment of the disease were observed until the patient relapse, then treatment. In the time period can be no recurrence, the patient suffers heart but they tend to feel anxious because of a halt treatment. Many patients have a doctor would ask at this point: "let me do the treatment, it is not because hopeless, so let me wait here Sia?" It is understood that in the past, because the pause treatment days, doctors think there are What better way to prolong the patient's survival. Now targeted drugs with low toxicity and chemotherapy drugs, if good results, the doctor can use to maintain the drug treatment, control the symptoms, without making any pause, the patient's "sense die" may also be greatly weakened.
Future cancer treatments will be selected based genotyping
Lu Shun said, with the exception of targeted mutations in the epidermal growth factor receptor targeted drugs for treatment, but last year, the United States has just approved another targeted therapy using oral azole grams Platini, will be in China this year, six are expected to month approved the listing. It is understood that it is a suitable drug treatment ALK gene mutation. The presence of this mutation in patients with lung cancer accounting for a non-smoker non-small cell carcinoma in about 5% of patients can prolong progression-free survival of approximately 10 months.
According to reports, now in clinical, histological usually from the perspective of the lung is divided into non-small cell lung cancer and small cell lung cancer. Among them, non-small cell lung cancer can be subdivided into adenocarcinoma, squamous cell carcinoma and large cell carcinoma. But if the gene from the perspective of non-small cell lung cancer can be divided into at least the current EGFR (epidermal growth factor receptor) gene mutant and wild-type EGFR gene. Lu Shun said: "With the continuous development of biological targeted therapies in recent years, doctors tend to come from the perspective of genetic typing of lung cancer, but for different genetic types of lung cancer to develop appropriate treatment programs will be the future of lung cancer treatment modalities trend. Currently, more genotyping and epidemiological being studied. "
Lu Shun said, in recent years, targeted drugs in the treatment of lung cancer made significant progress, but needs to be emphasized is that any drugs are not excessive "deification." Because any kind of targeted drugs can not be suitable for all patients, are required to vary. Only patients had molecular targeted drugs target the drug to its role, so genetic testing will become an important basis for guiding the clinical use of targeted therapy.
According to reports, the cumulative incidence of tumors in vivo because of a variety of driver genes (including oncogenes, tumor suppressor genes) mutations, coupled with external stimuli caused by adverse factors. Thus, the gene can be detected in patients condition and accurate analysis remedy. But now, lung cancer treatment efficiency is still low, which in addition to the complex pathogenesis of cancer and patients about individual differences, but also with previous drug treatment of lung cancer patients with a certain blindness inseparable. With experience in many lung cancer patients often choose related drugs, can this way, the disease has not only improved, but there may be artificially overtreatment.
Lu Shun said that in future doctors as long as the patient's pathological specimens for genetic testing and detection of pathologic subtypes, and then select the appropriate chemotherapy or targeted therapies for symptomatic treatment based on test results, will be able to truly individualized treatment of lung cancer.