非小細胞肺癌罕見的驅動基因突變之簡介

10.6666/ClinMed.202106_87(6).0060

楊善堯；邱昭華

非小細胞肺癌（non-small cell lung cancer, NSCLC） ； 驅動基因突變（driver mutation） ； 標靶藥物治療（targeted therapy）

臨床醫學月刊

87卷6期（2021 / 06 / 25）

360 - 366

繁體中文

因為癌症在十大死因中居高不下的排名，國人對於癌症的關注也日益高漲。肺癌在所有癌症死亡率的比例連年持續攀升，更是令人聞風色變。根據國健署的公開資料，以民國107年為例，肺癌發生率為所有癌症的第三位，死亡率則是所有癌症不分男女的第一位。將罹患癌症病人以性別區分來觀察，肺癌在女性與男性發生率排名都在第二位。大部分的肺癌病理組織學型態為非小細胞肺癌。以民國107年為例，男性的非小細胞肺癌占所有肺癌的89.7%，女性的非小細胞肺癌占所有肺癌的98.5%。非小細胞肺癌的範疇之中，以肺腺癌的比例最高，女性罹患肺腺癌比例占女性全部肺癌的比例甚至逼近90%。在過去以化學治療為轉移性肺癌治療主軸的時代，肺癌病人在接受治療的時候，除了遭受疾病病程的痛苦之外，還要面對伴隨化學治療而生的不等程度之副作用，導致部分病人無法完成療程，甚至抗拒治療。隨著標靶藥物治療（targeted therapy）的進展以及腫瘤基因檢測可近性的增加，現代的肺癌病人有越來越多的治療選擇。表皮生長因子受體（EGFR）和間變性淋巴瘤激酶（ALK）基因的突變是非小細胞肺癌較常見的驅動基因突變（driver mutation）。除此之外，尚有一些雖然罕見但臨床上一樣重要的驅動基因突變存在於非小細胞肺癌。本文旨在簡介一些非小細胞肺癌罕見但重要的驅動基因突變，包括ROS-1、RET、NTRK、MET、及BRAF。

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