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Challenges in Implementing Personalized Medicine for Lung Cancer within a National Healthcare System

机译：在国家医疗保健系统中实施针对肺癌的个性化医学的挑战

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The traditional approach to the treatment of advanced non-small cell lung cancer (NSCLC) relied on the uniform use of cytotoxic chemotherapy. Over the last eight years, this paradigm of care has been shifting towards the use of molecularly targeted agents. Epidermal growth factor receptor (EGFR) mutations have emerged as an important biomarker for these targeted agents and multiple studies have shown that tyrosine kinase inhibitors (TKI) that inhibit EGFR are superior to traditional chemotherapy in patients possessing an EGFR mutation. Nationally funded health care systems face a number of challenges in implementing these targeted therapies, most related to the need to test for biomarkers that predict likelihood of benefiting from the drug. These obstacles include the challenge of getting a large enough tissue sample, workload of involved specialists, reliability of subtyping in NSCLC, differences in biomarker tests, and the disconnect between the funding of drugs and the related biomarker test. In order to improve patient outcomes, in a national healthcare system, there is a need for governments to accept the changing paradigm, invest in technology and build capacity for molecular testing to facilitate the implementation of improved patient care.
机译：治疗晚期非小细胞肺癌（NSCLC）的传统方法依赖于细胞毒性化学疗法的统一使用。在过去的八年中，这种护理模式已经转向使用分子靶向药物。表皮生长因子受体（EGFR）突变已成为这些靶向药物的重要生物标志物，多项研究表明，抑制EGFR的酪氨酸激酶抑制剂（TKI）在具有EGFR突变的患者中优于传统化疗。国家资助的卫生保健系统在实施这些靶向疗法时面临许多挑战，其中大部分与测试生物标志物以预测受益于该药物的可能性有关。这些障碍包括挑战：获取足够多的组织样本，相关专家的工作量，NSCLC分型的可靠性，生物标志物测试的差异以及药物和相关生物标志物测试之间的脱节。为了改善患者的预后，在国家医疗保健系统中，政府需要接受不断变化的范例，投资技术并建立分子测试的能力，以促进实施改善的患者护理。

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