Genomic medicine, precision therapy, targeted therapy...


　　a new era of cancer prevention and treatment is coming

　　World wave of technological innovation

　　◎Our reporter Liu Xia

　　Just a few decades ago, cancer was an almost invincible disease.

Many cancers are already at an advanced stage when they are diagnosed, the treatment effect is not good, the prognosis is poor, and the survival rate of patients is low.

　　However, the "Scientific American" magazine website pointed out in a recent report that due to the rapid development of cancer biology, genomic medicine, diagnostic medicine, precision medicine, immuno-oncology, and drug discovery, oncologists are now able to control cancer. stronger.

They can already train the full power of the immune system to fight cancer and prevent cancer from recurring.

More importantly, the rapid development of next-generation genome sequencing technology has greatly reduced its cost, opening the door to better prevention, early detection and targeted therapy, and prevention of cancer recurrence.

This means that more lives will be saved in the near future.

　　New screening: early detection of cancer

　　If cancer can be detected early, then almost all cancers can be cured, or it can be well controlled.

For example, most ovarian cancer is already at an advanced stage when diagnosed, and less than a quarter of patients can live more than 5 years after diagnosis.

But among 15% of early-detected ovarian cancer patients, 95% can live past 5 years.

　　Currently, there are only a few cancers that can be diagnosed early using precision screening. For example, mammography is used to screen for breast cancer, Pap smear is used to screen for cervical cancer, colonoscopy is used to screen for colon cancer, and PSA is used. Screening for prostate cancer and low-resolution CT scans for lung cancer, etc.

There is currently no effective screening method for other cancers, and these cancer patients together account for 60% of cancer deaths.

　　"Scientific American" pointed out that some new screening methods help doctors find cancer as soon as possible.

　　One method is liquid biopsy.

For a long time, doctors need to perform some invasive tissue biopsies to diagnose certain cancers.

But now, they can analyze blood samples (the "liquid" in a liquid biopsy) to find "cues" of cancer-this is because each type of cancer releases cancer cells and DNA fragments into the blood, and analyzing them can reveal that they are getting worse. The nature of the tumor.

　　Another new screening method is to use epigenetics—chemical modifications to DNA and proteins without changing the way genes are coded. These modifications can determine whether genes are turned on or off.

In June last year, a large research team published a report in the Annals of Oncology that it was possible to detect as many as 50 different types of cancer by analyzing only one of the chemical modifications—adding a methyl group to the DNA molecule.

　　Lung cancer is one of the easiest cancers to find with this method.

Nowadays, doctors can use continuous low-resolution CT scans to monitor whether there are lung nodules in patients at high risk of lung cancer, and supplemented by liquid biopsy, they will be able to discover some special molecules that can distinguish benign or malignant nodules, as scientists recently reported A molecule that could reveal lung cancer was found in the plasma.

　　In addition, patients can also use some known information to reduce the chance of developing cancer.

For example, women with mutations in the tumor suppressor genes BRCA1 and BRCA2 are susceptible to breast and ovarian cancer. They can receive preventive treatments called biomodulators to reduce the chronic inflammation that causes cancer.

　　Targeted therapy: improve the treatment effect

　　Doctors will soon be able to understand the initial genetic composition of tumors and classify them according to the patients' genes to optimize treatment decisions. This is the essence of precision medicine.

　　This precise treatment of cancer can bring about tremendous changes.

In a study of 2000 patients with non-small cell lung cancer, the median survival time of patients who did not receive molecular testing or targeted cancer therapy such as protein kinase inhibitors was only 10 months, but those who received molecular testing and received The median survival of patients treated with protein kinase inhibitors is close to 4 years.

　　Since doctors have targeted the two most common mutations that cause non-small cell lung cancer, molecular testing is expected to change the treatment of this type of cancer.

The research results also show that optimizing treatment through precision medicine can reduce the cost of care.

　　Multi-pronged approach: preventing cancer recurrence

　　In addition to early detection of cancer and targeted treatment, in order to better improve the effect of cancer treatment, post-treatment care (also called follow-up care) is also very important. In this regard, the biggest challenge is to predict whether the cancer will recur. , When to relapse and to prevent its recurrence.

　　The report also pointed out that the rapid development of liquid biopsy and next-generation sequencing technology has enabled doctors to better detect the "remaining soldiers" of cancer in the human body, so that people can better predict and prevent cancer recurrence.

　　First, the detection and characterization of residual cancer cells can help doctors formulate appropriate treatments to curb the disease.

In addition, the use of new technology can quantify the patient's immune status-which largely determines whether the cancer recurs, and select immunotherapy based on this, thereby helping to prevent the recurrence of cancer.

　　In addition, the follow-up care of cancer nowadays means more than just monitoring the recurrence of the disease.

There is increasing evidence that changes in health status and lifestyle, especially changes in exercise, nutrition and general health status, will help cancer patients improve survival rates, improve recovery status, and reduce recurrence.

　　Moreover, more scientific drugs tailored to patients can bring them better treatment results, prolong survival time and reduce medical costs.

In the future, early classification of patients and targeted and effective treatment will bring the best results, which will reduce the hospitalization rate of cancer patients, reduce social medical costs, and save lives.