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中华临床医师杂志(电子版) ›› 2021, Vol. 15 ›› Issue (02) : 123 -128. doi: 10.3877/cma.j.issn.1674-0785.2021.02.008

所属专题: 文献

综述

非小细胞肺癌靶向PET显像的临床研究进展
周欣1, 张慧媛1, 王淑静1, 朱华1, 杨志1, 李囡1,()   
  1. 1. 100142 北京,北京大学肿瘤医院暨北京市肿瘤防治研究所核医学科 国家药监局放射性药物研究与评价重点实验室 恶性肿瘤发病机制及转化研究教育部重点实验室
  • 收稿日期:2020-08-17 出版日期:2021-02-15
  • 通信作者: 李囡
  • 基金资助:
    国家自然科学基金(81871387); 北京市自然科学基金(7202027)

Recent clinical progress of targeted PET imaging for non-small cell lung cancer

Xin Zhou1, Huiyuan Zhang1, Shujing Wang1, Hua Zhu1, Zhi Yang1, Nan. Li1,()   

  1. 1. Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing 100142, China
  • Received:2020-08-17 Published:2021-02-15
  • Corresponding author: Nan. Li
引用本文:

周欣, 张慧媛, 王淑静, 朱华, 杨志, 李囡. 非小细胞肺癌靶向PET显像的临床研究进展[J/OL]. 中华临床医师杂志(电子版), 2021, 15(02): 123-128.

Xin Zhou, Huiyuan Zhang, Shujing Wang, Hua Zhu, Zhi Yang, Nan. Li. Recent clinical progress of targeted PET imaging for non-small cell lung cancer[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2021, 15(02): 123-128.

非小细胞肺癌(NSCLC)精准治疗的快速发展离不开靶向和免疫药物的临床应用,其中最受瞩目的是单克隆抗体(mAbs)和酪氨酸激酶抑制剂(TKIs)。将放射性核素标记的mAbs及TKIs作为分子探针对NSCLC患者进行正电子断层显像(PET),可通过无创的方式完成相应靶点表达水平的检测。mAbs-PET的显像靶点是以程序性死亡蛋白及其配体[PD-(L)1]为代表的细胞表面蛋白受体,临床转化研究表明mAbs-PET显像可检测相应受体的表达程度,并且肿瘤的摄取程度可提示临床预后。TKI-PET的显像靶点是以表皮生长因子受体(EGFR)为代表的酪氨酸激酶,研究表明TKI-PET显像可提示相应激酶靶点存在与否,肿瘤的摄取程度与相应激酶表达程度及TKI治疗疗效相关,同时TKI-PET显像可辅助筛选临床可能受益的患者,对临床治疗有指导意义。非侵入性靶向PET显像可直观显示药物在体内的代谢分布情况并进行定量研究,可避免依赖于组织活检的有创性受体检测,同时其全身大视野成像可进行体内所有病灶相关特征的观察,从而更好的辅助疾病诊断及治疗疗效预测。本综述总结了目前关于mAbs-PET及TKI-PET用于NSCLC的相关临床转化研究现状,并阐述其对于NSCLC临床个体化治疗的作用及意义。

The rapid development of precision treatment mode of non-small cell lung cancer (NSCLC) is dependent on the clinical promotion and application of monoclonal antibodies (mAbs) and tyrosine kinase inhibitors (TKIs). Non-invasive positron emission tomography (PET) in NSCLC patients with radio-labeled mAbs and TKIs as molecular probes can detect the expression level of corresponding targets. Targets of mAbs-PET are protein receptors on cell surface represented by programmed death protein and its ligand [PD-(L) 1]. Clinical translational studies showed that mAb-PET could detect the expression of corresponding receptor, and the uptake of tumor indicated clinical prognosis. Targets of TKI-PET imaging is tyrosine kinase represented by epidermal growth factor receptor (EGFR). Studies have shown that TKI-PET could indicate whether the corresponding kinase target existed, and the uptake of tumor was related to the expression of the corresponding kinase and the therapeutic effect of TKI. Meanwhile, TKI-PET can assist in screening patients who may benefit from TKI therapy, which is of great clinical significance. Non-invasive targeted PET imaging could display and quantify metabolic distribution of drugs in vivo, which can avoid the invasive receptor expression test relying on tissue biopsy. At the same time, whole-body imaging of PET could identify characteristics of all lesions, thus assisting in diagnosis and prediction of therapeutic effects. This review summarizes researches concerning clinical translation of mAb-PET and TKI-PET in NSCLC, and expounds their role and significance in clinical individualized treatment of this malignancy.

图1 非小细胞肺癌常用靶向药物及其作用靶点简化示意图
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