非吸烟者的肺癌:一篇综述
Cian Murphy1,2, Tej Pandya1,3, Charles Swanton1,4,5
1Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, United Kingdom.
JAMA
|October 20, 2025
概括
没有吸烟的人患肺癌占全球病例的15-20%. 识别可向的基因组变异,如EGFR突变,可以提高向治疗的存活率.
科学领域:
- 癌症学
- 基因组学
背景情况:
- 曾在一生中吸过不到100支烟的人患肺癌占全球肺癌病例的15%至20%.
- 在美国,女性的发病率高于男性.
- 腺癌是最常见的组织瘤,其中风险因素包括被动吸烟,和家族病史.
研究的目的:
- 为了突出从未吸烟者肺癌的独特基因组.
- 强调针对特定基因组变化的向疗法所带来的改善生存结果.
主要方法:
- 对肺癌患者组织学和基因组数据的分析.
- 从未吸烟者与吸烟者之间的突变特征比较.
- 基于分子特征和治疗类型的治疗结果的审查.
主要成果:
- 与吸烟者相比,从未吸烟者的瘤具有更高的可向基因组变异 (例如EGFR突变,ALK重组) (43%对EGFR,11%对ALK12%).
- 没有吸烟的人的瘤突变负担较低.
- 针对性治疗的晚期非小细胞肺癌的中位数存活时间超过3-5年,而没有针对性的肺癌则超过1-2年.
结论:
- 没有吸烟的人患肺癌的特点是更频繁的基因组变化.
- 针对性治疗,如氨酸激酶抑制剂,显著提高了这一群体的生存率.
- 全面的基因组测序对于从未吸烟的肺癌患者的治疗决定至关重要.
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