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동반생물학적표지자: 개인맞춤 암치료를 향한 경로 제공

Companion Biomarkers: Paving the Pathway to Personalized Treatment for Cancer

Michael J. Duffy|John Crown
대한진단검사의학회 (Korean Society For Laboratory Medicine)|2015.01|Laboratory Medicine Online|제5권 제1호|pp. 44-54

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배경: 동반생물학적표지자(Companion biomarker)는 특정 치료제와의 조합으로 이용되어 반응성 또는 심한 독성 가능성을 미리 예측할 수 있도록 도와주는 것이다. 이 논문에서는 암 환자에서 치료의 방향을 제시하는 데 있어서의 동반생물학적표지자의 역할이 검토될 것이다. 내용: 유방암에서의 에스트로젠 수용체나 HER 2 (human epidermal growth factor receptor 2)와 같은 이미 확립된 동반생물학적표지자들 뿐 아니라, 최근 수년간 새로운 몇몇 동반생물학적표지자들이 등장하였다. 이들은 항-상피세포 성장인자 수용체 항체(anti-epidermal growth factor receptor antibodies; cetuximab 또는 panitumumab) 치료효과를 보일 것으로 예상되는 진행성 대장암환자들을 선택하기 위한 v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS) 돌연변이, 진행성 비소세포성폐암(non–small cell lung cancer, 비소세포성폐암) 환자들 중 타이로신활성효소 억제제(tyrosine kinase inhibitors; gefitinib 또는 erlotinib) 치료 적용대상을 선택하기 위한 epidermal growth factor receptor (EGFR) 돌연변이, 항BRAF 제제(vemurafenib and dabrafenib) 치료 대상이 될 수 있는 진행성 흑색종 환자의 선별을 위한 v-raf murine sarcoma viral oncogene homolog B1 (BRAF) 돌연변이, 그리고 crizotinib에 치료효과가 있을 것으로 보이는 비소세포성폐암 환자들을 찾아내기 위한 anaplastic lymphoma receptor tyrosine kinase (ALK) 전위 등이다. 요약: 동반생물학적표지자의 활용은 약제의 효과 향상, 독성 감소를 가져올 것이며, 암 치료에 대한 보다 개인별 최적화된 접근을 가능하게 할 것이다.

Abstract

Background: Companion biomarkers are biomarkers that are used in combination with specific therapies and that prospectively help predict likely response or severe toxicity. In this article we review the role of companion biomarkers in guiding treatment in patients with cancer. Content: In addition to the established companion biomarkers such as estrogen receptors and HER 2 (human epidermal growth factor receptor 2) in breast cancer, several new companion biomarkers have become available in recent years. These include v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations for the selection of patients with advanced colorectal cancer who are unlikely to benefit from anti-epidermal growth factor receptor antibodies (cetuximab or panitumumab), epidermal growth factor receptor (EGFR) mutations for selecting patients with advanced non-small cell lung cancer (NSCLC) for treatment with tyrosine kinase inhibitors (gefitinib or erlotinib), v-raf murine sarcoma viral oncogene homolog B1 (BRAF) mutations for selecting patients with advanced melanoma for treatment with anti-BRAF agents (vemurafenib and dabrafenib), and anaplastic lymphoma receptor tyrosine kinase (ALK) translocations for identifying patients with NSCLC likely to benefit from crizotinib. Summary: The availability of companion biomarkers should improve drug efficacy, decrease toxicity, and lead to a more individualized approach to cancer treatment.

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