非小细胞肺癌治疗后重复活检研究进展及意义OA

Non-small cell lung cancer(NSCLC)accounts for approximately 80%～85%of all lung cancer cases,and most patients are diagnosed at an advanced stage.With the discovery of driver genes and the development of targeted thera-pies,the treatment paradigm of NSCLC has entered the era of precision medicine.However,acquired resistance to targeted therapies is almost inevitable,posing significant challenges for disease management after treatment.Rebiopsy,which in-volves obtaining tumor tissue or bodily fluid samples after disease progression or resistance,enables dynamic assessment of tumor molecular characteristics and histological changes and has become an important strategy for guiding individualized treat-ment.Studies have shown that repeated biopsy can identify epidermal growth factor receptor-tyrosine kinase inhibitor resist-ance-related mutations,secondary mutations in the anaplastic lymphoma kinase domain,and mesenchymalepithelial transition factor bypass activation,as well as detect non-genetic resistance patterns such as histological transformation to small cell lung cancer or squamous cell carcinoma.These findings provide critical evidence for the sequential application of subsequent tar-geted therapy and the adjustment of chemotherapy or immunotherapy.In addition,rapid advances in liquid biopsy technolo-gies have enabled minimally invasive and dynamic monitoring of tumor evolution through biomarkers such as circulating tumor DNA,circulating tumor cells,DNA methylation,metabolomics,and tumor-educated platelets.These approaches serve as important complements to tissue biopsy.Overall,repeated biopsy provides comprehensive insights into resistance mechanisms at both molecular and phenotypic levels,facilitating optimized therapeutic decision-making and advancing precision medicine in NSCLC.In the future,the combined application of tissue biopsy and liquid biopsy,together with advances in detection technology,is expected to further improve the level of individualized management and clinical benefits of NSCLC.