晚期肺黏液腺癌的治疗进展

Prospect on medical treatment of pulmonary mucinous adenocarcinoma

肺黏液腺癌是肺腺癌的一类亚型,其中浸润型黏液腺癌(invasive mucinous adenocarcinoma,IMA)最常见,易被误诊为肺炎,目前病因和发病机制尚不清楚,可能与基因突变等因素有关。由于其相对罕见,相关研究较少,目前指南未单独对其治疗进行指导。IMA患者常出现KRAS突变,索托拉西布可能对KRAS G12C突变的IMA有效。NRG1融合被认为是IMA的重要驱动基因,阿法替尼可能对治疗NRG1融合/重排的IMA有效。IMA患者细胞程序性死亡-配体1表达率非常低,而B7-H3表达率较高,因此B7-H3可能是一个潜在的免疫治疗靶点。

Pulmonary mucinous adenocarcinoma is a subtype of lung adenocarcinoma,among which invasive mucinous adenocarcinoma(IMA)is the most common subtype and is easily misdiagnosed as pneumonia.Its etiology and pathogenesis are unclear and may be related to gene mutations and other factors.Due to its relative rarity and few related studies,guidelines do not provide advices on its treatment.KRAS mutations are common in IMA patients,and Sotorasib may be effective against KRAS G12C mutated IMA.NRG1 fusion is considered to be an important driver of IMA,and afatinib may be effective in treating IMA with NRG1 fusion/rearrangement.PD-L1 expression is very low in IMA patients,while B7-H3 expression is high,so B7-H3 may be a potential immunotherapeutic target.