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吴一龙教授点评ASCO年度进展:把握精准医学发展方向

2015-01-29 佚名 中国医学论坛报

1月20日,美国临床肿瘤学会(ASCO)在《临床肿瘤学杂志》(J Clin Oncol)上在线发布了《ASCO年度报告:2015临床肿瘤学进展》,今年正值ASCO发布年度报告的第10个年头,报告中的“十年回顾――历数自引入年度报告以来癌症治疗方面的巨大变化”和“十年前瞻――肿瘤治疗领域下一个10年的趋势预测”为我们描绘了临床肿瘤学发展的宏伟蓝图。广东省人民医院吴一龙教授总结了报告中的十年进展,并

1月20日,美国临床肿瘤学会(ASCO)在《临床肿瘤学杂志》(J Clin Oncol)上在线发布了《ASCO年度报告:2015临床肿瘤学进展》,今年正值ASCO发布年度报告的第10个年头,报告中的“十年回顾――历数自引入年度报告以来癌症治疗方面的巨大变化”和“十年前瞻――肿瘤治疗领域下一个10年的趋势预测”为我们描绘了临床肿瘤学发展的宏伟蓝图。广东省人民医院吴一龙教授总结了报告中的十年进展,并对十年前瞻的内容进行了解读。以下为详细内容。

在谈及《ASCO年度报告:2015临床肿瘤学进展》中十年回顾内容的印象和特点时,吴教授总结为以下6点。

1.主要着眼临床肿瘤学角度来选取过去10年有重大影响力的事件,未牵涉基础研究。即如貌似基础研究的大规模基因组分析和表观基因组学的研究和项目也是立足转化医学角度,使得临床医生能以清楚的脉络感受临床肿瘤学的发展,这些对临床肿瘤医生非常重要,也非常有意思。

2.进展中提到的EGFR抑制剂、HER2药物、靶向多分子通路、新靶点新药物以及绘制基因组图谱等内容,贯彻的均是同一方向――肿瘤的治疗已经进入精准的时代,针对明确的靶点开展诊治已成为一股历史的潮流,体现在疗效非常好,患者的生存获益和生活质量改善远远超过以往的化学治疗药物。

3.临床医学的进步完全离不开对人类基因组学的认识,随着对基因组学的深入认识,肿瘤发生发展的驱动基因、驱动通路不断被发现,才能促使当今的临床实践发生巨大改变。在过去10年,转化医学扮演了非常重要的角色。

4.免疫治疗已脱胎换骨,着眼的机理完全不同于过去,对阻断免疫抑制点开展的研究工作有力地推动了免疫治疗的发展。

5.当前已从晚期肿瘤的治疗向筛查以便早期发现肿瘤迈出了关键一步,如乳腺癌、前列腺癌、肺癌等的筛查取得了实质性的进步,这对改善肿瘤患者生存的贡献最大。

6.观念的转变,将肿瘤患者生活质量的提高放到了非常重要的位置,目的是不仅使患者生存得更长,而且生活得更好。

对于该报告中未来10年发展的展望,吴教授称其实与他的思考不谋而合,已在很多场合中不断提到。例如,精准治疗毫无例外也会带来耐药的问题,那么如何看待并认识耐药的机制以及克服耐药便会成为未来很长一段时间需要认真对待的问题,解决此问题将会不断提高我们的治疗水平。液体活检是一个综合效应,表现在将来基因组学不仅是用于诊断和发现疾病,而且能用于监测患者病情以及指导治疗策略的随时调整,这具有重大和特殊的意义。该报告以纳米紫杉醇为例提到了纳米技术,其实该药对于肿瘤患者生存的改善不像靶向药物那么明显,但代表了一个方向,即在传统药物基础上进行技术的改进也能发挥更大的效应。所以,未来这些新技术用于肿瘤的筛查、诊断、治疗等方面会具有重大的作用。总体而言,未来的发展是精准医学将会更精更准,如果大家对于报告中所提到的方向能把握住,那么临床肿瘤学的发展会走向一条更快、更好、更健康的道路。

在被问及我国在未来这些发展方向上与国外的差距时,吴教授表示,其实我们已认识到了这些发展方向,从技术层面上已开始着手开展,如国内已开始液体活检、纳米技术的研究,但最大的问题是我们缺乏携手共同开展相应研究工作的大团队;其次,所有这些未来方向的假说理念将来都必须由临床试验来证实,而这些创新性临床试验可能会遭遇伦理及政策等方面的障碍,只有去克服才能发展;第三,创新精神还不够,对于新理念还缺乏深入挖掘的想法和行动。



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    2015-11-02 quxin068
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    2015-02-01 116.247.99.**

    精准医学大热

    0

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  6. [GetPortalCommentsPageByObjectIdResponse(id=1915658, encodeId=71c6191565829, content=<a href='/topic/show?id=8d833e840ae' target=_blank style='color:#2F92EE;'>#发展方向#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37840, encryptionId=8d833e840ae, topicName=发展方向)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=279b407, createdName=shanyongle, createdTime=Wed Feb 11 07:57:00 CST 2015, time=2015-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1949641, encodeId=7c0b194964121, content=<a href='/topic/show?id=8c89340503e' target=_blank style='color:#2F92EE;'>#医学发展#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=34050, encryptionId=8c89340503e, topicName=医学发展)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Fri Aug 21 05:57:00 CST 2015, time=2015-08-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1938460, encodeId=26ad193846055, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Mon Nov 02 03:57:00 CST 2015, time=2015-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=14931, encodeId=9c0e14931b6, content=精准医学大热, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=116.247.99.**, createdTime=Sun Feb 01 14:29:00 CST 2015, time=2015-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1402938, encodeId=4c6514029388c, content=<a href='/topic/show?id=ebbde6353be' target=_blank style='color:#2F92EE;'>#精准#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76353, encryptionId=ebbde6353be, topicName=精准)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83epQX9hfEIBiaPg0e9KvLYVBCSGYydH6K6OQxBh3RaOC0TYP9HYy2v0XdHib1LFnZNU5Siak0P8oh8Aqw/132, createdBy=acd92440184, createdName=shijzhiewnjhch, createdTime=Sat Jan 31 06:57:00 CST 2015, time=2015-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=14846, encodeId=2d8014846f5, content=肺癌,乳腺癌可以,其他肿瘤还难, beContent=null, objectType=article, channel=null, level=null, likeNumber=243, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Thu Jan 29 20:58:00 CST 2015, time=2015-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=14823, encodeId=c3701482373, content=精准医学, beContent=null, objectType=article, channel=null, level=null, likeNumber=167, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=223.104.5.**, createdTime=Thu Jan 29 19:15:00 CST 2015, time=2015-01-29, status=1, ipAttribution=)]
    2015-01-29 lovetcm

    肺癌,乳腺癌可以,其他肿瘤还难

    0

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    2015-01-29 223.104.5.**

    精准医学

    0

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