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分子诊断、临床试验表征与癌基因驱动肺癌少数族裔患者的精准医学

Molecular Diagnosis, Clinical Trial Representation, and Precision Medicine in Minority Patients with Oncogene-Driven Lung Cancer.

作者信息

Bhatt Ahan, Yone Nang, Lalla Mumtu, Jeon Hyein, Cheng Haiying

机构信息

Department of Internal Medicine, NYC Health + Hospitals/Jacobi Medical Center, Bronx, New York, NY 10461, USA.

Department of Oncology, Albert Einstein College of Medicine, Bronx, New York, NY 10461, USA.

出版信息

Cancers (Basel). 2025 Jun 11;17(12):1950. doi: 10.3390/cancers17121950.

Abstract

Lung cancer remains the leading cause of cancer-related death in the US and worldwide. Recent advances in molecular profiling and targeted therapies have revolutionized the management of non-small cell lung cancer (NSCLC), particularly in oncogene-driven subtypes. These therapies selectively target key molecular alterations in , , , , , , (), , and , resulting in substantial improvements in survival rates and quality of life for lung cancer patients. However, disparities in molecular diagnostics and precision treatments persist, disproportionately affecting minority patients. These inequities include underrepresentation in clinical trials, disparities in molecular testing, and barriers to treatment access. The limited participation of racial and ethnic minorities in landmark clinical trials raises concerns about the generalizability of findings and their applicability to diverse populations. In this review, we examine the current landscape of molecular diagnosis and precision medicine in minority patients with oncogene-driven lung cancer, highlighting challenges, opportunities, and future directions for achieving equity in precision oncology. Additionally, we discuss differences in the prevalence of oncologic driver mutations across populations and emphasize the urgent need for greater diversity in clinical research. Addressing these gaps is critical to improving survival outcomes and ensuring equitable access to personalized lung cancer care for all patients.

摘要

肺癌仍然是美国和全球癌症相关死亡的主要原因。分子谱分析和靶向治疗的最新进展彻底改变了非小细胞肺癌(NSCLC)的治疗方式,尤其是在致癌基因驱动的亚型中。这些疗法选择性地靶向 、 、 、 、 、 ()、 、 和 中的关键分子改变,从而使肺癌患者的生存率和生活质量得到显著提高。然而,分子诊断和精准治疗方面的差距依然存在,对少数族裔患者的影响尤为严重。这些不平等现象包括在临床试验中的代表性不足、分子检测方面的差距以及治疗获取障碍。种族和少数族裔在具有里程碑意义的临床试验中的参与有限,这引发了人们对研究结果的普遍性及其对不同人群适用性的担忧。在本综述中,我们审视了致癌基因驱动的肺癌少数族裔患者的分子诊断和精准医学现状,强调了在精准肿瘤学中实现公平的挑战、机遇和未来方向。此外,我们讨论了不同人群中肿瘤驱动突变患病率的差异,并强调临床研究迫切需要更大的多样性。解决这些差距对于改善生存结果以及确保所有患者公平获得个性化肺癌治疗至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4355/12190301/e03014505e23/cancers-17-01950-g001.jpg

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