The trend of cancer treatment is targeted individualized medical treatment. On the Medical Diagnosis Conference held in Xiamen recently, experts pointed out that "auxiliary diagnosis" and "targeted treatment" are two most important tools for individualized precise treatment of tumor. Compared with chemotherapy, auxiliary diagnosis can better enhance the survival rate of some patient groups, improve the treatment prognosis and reduce the healthcare expenditure.
Auxiliary diagnosis+ targeted treatment= precision medicine
Due to the existence of genetic diversity among individuals, the treatment methods and effects for cancer will also vary among the patients. The conventional treatment strategy of "using the same treatment scheme for the same disease" can no longer satisfy the treatment demands of the patients. Individualized medicine has become an inevitable trend. As the main means of individualized medicine, "targeted treatment" can target and kill malignant tumor cells through the selection of gene or molecules, but almost will not affect normal cells. It is highly effective but with low toxicity. As an in vitro diagnosis technique associated with the target drug, "auxiliary diagnosis" screens the patient group suitable for taking drugs from different types of patients mainly by testing the protein expression level and type of gene mutation in human body and carries out targeted and individualized treatment. With the close cooperation between diagnosis and pharmacy in professional knowledge and technologies, auxiliary diagnosis and targeted treatment have become two most important tools for realizing precision medicine.
Professor Zhang Jie, director of pathology department of Shanghai Chest Hospital, pointed out, "We have entered an era of individualized medicine, in which auxiliary diagnosis is playing an indispensible and important role, which provides important information for guiding the treatment and promoting the individualized medicine. Precise results of auxiliary diagnosis can provide a powerful basis for clinical selection of suitable targeted drugs, so as to customize the best treatment scheme for the patients and enable them to gain the greatest benefits for their survival."
The scheme of treatment after testing is better
"In recent years, the number of NSCLC patients has shown a distinctive trend of rising in China, which accounts for 80% of lung cancer patients." Experts claim that according to the clinical statistics, 70% of the NSCLC patients are already under late stage when they are diagnosed. They are insensitive to chemoradiotherapy, which has resulted in a high mortality rate. The median survival time of these patients is only 3 months. The five-year survival rate is only 15%. "For these lung cancer patients under the middle and late stages, if the driver gene can be spotted, they can then be treated with targeted drugs." Cui Tongjian said, among the Asian lung cancer patients, the known driver gene has been spotted among 87% of the patients, among which 81% of driver genes have had a clear targeted suppressor. 66% of the patients can receive an individualized targeted treatment with the drugs already distributed in the market.
Epidermal growth factor receptor (EGFR) is a "frequent" driver gene of non-small cell lung cancer. The proportion of EGFR sensitiveness mutation among the Asian patients reaches 30% to 40%, which is far higher than that of Western countries. "With the development of precise treatment, for the treatment of lung cancer patients, we suggest testing before treatment, which not only can provide basis for prescription of doctors, but also can save many unnecessary expenditures for the patients." The Rules of Diagnosis and Treatment for Primary Lung Cancer in China (2015 edition) issued by the National Health and Family Planning Commission of China also points out that for late-stage NSCLC, glandular cancers or other types of lung cancers containing glandular cancer element, the patients should receive a gene mutation test such as EGFR and ALK while being diagnosed. For this, Professor Cui Tongjian points out, "For the lung cancer patients that are positive in gene mutation, identifying the NSCLC patients with positive ALK and EGFR is decisive to the selection of targeted treatment strategy. It is the best scheme for diagnosis and treatment of lung cancer at present to test before treatment and use auxiliary diagnosis to guide targeted treatment." He also expresses that the gene testing level of China has reached the internationally advanced level, so it is in fact unnecessary to go abroad to receive test and treat the cancer.
Precise gene testing is the key to realization of precision medicine