[CSCO2014]结直肠癌原发灶无症状+转移灶不可切除:在个体化的原则下积极化疗——Claus-Henning Kohne教授访谈
Claus-Henning Kohne教授是德国奥尔登堡大学肿瘤科主任,兼任欧洲药品管理局(EMA)顾问,ESMO eLearning主席,ESMO教育委员会胃肠癌(2009-2012)主席,《ESMO结直肠癌诊治共识指南》执笔人,泛欧结肠癌辅助治疗试验创始成员。
Oncology Frontier: Could you please talk about the development trend of the targeted therapy of colorectal cancer?
《肿瘤瞭望》:能否请您谈谈大肠癌靶向治疗的发展趋势?
Dr Köhne: The issue of a better selection of patients is a good example in colorectal cancer. We have seen that EGFR inhibitors, cetuximab and panitumumab, are agents that nicely control the disease in patients who have KRAS X02 mutations. We have learned that other RAS mutations such as N1s are also important. So we are now able to better select the number of patients who will benefit most from such a treatment. In the future, we may see additional advances because we have seen data showing that it does matter whether the colon primary is in the left or the right colon. This may lead to further development in the future. We also know that other downstream proteins have an important role in signaling the EGFR pathway. So in the future, we may see mTOR, PI3kinase, NKT or other inhibitors that may have an effect in the treatment outcome. This is unknown so far and we have clinical trials ongoing investigating whether this is the right direction or not.
Köhne博士:选择更合适的患者是大肠癌靶向治疗的关键问题。我们已经知道,表皮生长因子受体(EGFR)抑制剂,西妥昔单抗和帕尼单抗,能够很好地控制发生KRAS X02基因突变的患者的病情。我们已经了解到,这对其他RAS突变,如N1s也很重要。因此现在我们能很好地选择出那些从这种靶向治疗中获益最大的患者。将来我们会取得更大的进步。因为已经有研究显示,原发病灶在左半结肠还是在右半结肠至关重要,今后可能将有进一步的发展。此外,其他下游蛋白在EGFR信号通路中起重要作用。因此,将来我们也许能看到mTOR,PI3激酶,NKT细胞或其他抑制剂发挥治疗效果。不过这一点目前尚不清楚,这个方向的正确性目前正处于临床试验的验证中。
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