用于晚期或转移性肺癌的化疗发展缓慢，在1948年至21世纪初期间进展有限。在此之前，仅有很少达到了长期OS获益，因此对于化疗的益处一直存在争议。幸运的是，分子靶向药物正在彼时兴起。过去二十年间取得了惊人的进展。如今，许多药物可用于治疗癌基因驱动的肺癌患者。 靶向敏感EGFR突变的药物包括厄洛 替尼、吉非替尼、阿法替尼（afatinib）、达克替尼（dacomitinib）、埃克替尼（icotinib）、奥希替尼（osimertinib）和nazartinib。
15至20年前分子靶向药物的引入标志着一个新时代的开始。今天，免疫检查点抑制剂也已开启另一治疗模式。由于化疗和靶向药物直接作用在肿瘤上，这意味着耐药性最终会出现，而免疫疗法针对免疫系统，使一定比例的患者能够生存更长时间。在治疗开始后2年仍存活的晚期非小细胞肺癌（NSCLC）患者有些生存超过5年的。因此，晚期癌症治疗的新范例已经出现。
2018年6月28日和29日，面向肿瘤内科医师的Lung Cancer International Preceptorship在中国上海召开。场地提供方为同济大学附属上海市肺科医院。在这两天的时间里，我们举办了讲座和研讨会，旨在提高与会者对中国以及国际肺癌管理的了解。参加指导会议的24名代表中，绝大多数在中国医院工作。会议主题范围涵盖了肺部恶性肿瘤的筛查、诊断和病理学以及各种类型的治疗。会议最后环节为参观上海市肺科医院。
Chemotherapy for advanced or metastatic lung carcinoma has evolved slowly with limited progress between 1948 and the beginning of the 21st century. Until then, only minimal gains in long-term OS had been achieved, and the benefit of chemotherapy was discussed in a controversial manner. Fortunately, this was the very time when the rise of molecularly targeted agents started.
The introduction of molecularly targeted agents 15 to 20 years ago marked the beginning of a new era. Today, immune-checkpoint–inhibiting drugs have established yet another level of treatment. While both chemotherapy and targeted agents exert their effects directly at the tumor, which implies the eventual emergence of resistance, immunotherapy targets the immune system, enabling a certain percentage of patients to survive over extended periods of time.
On 28th and 29th June, 2018, a Lung Cancer International Preceptorship directed towards medical oncologists took place in Shanghai, China. The scientific provider was the Shanghai Pulmonary Hospital affiliated to the local Tongji University. In the course of these two days, lectures and workshops were held with the aim of improving the participants’ knowledge about lung cancer management in China and internationally.
