基因组学研究是当今肺癌的一大研究热点，在这方面您有何见解？

　　Celine Mascaux：我认为基因组学是肺癌临床治疗的未来，目前我们根据特异的肿瘤标志物应用基因学药物为患者选择最优化的治疗方案，且它们的临床价值也正如我们所希望的那样，不仅提高了疾病的缓解率而且降低了毒副作用。

　　在临床试验中是否有必要对患者的基因亚型进行分类？目前临床常用的基因学检测技术有哪些？

　　Celine Mascaux：这是肯定的，对患者进行基因分型可以帮助我们制定最优化的治疗策略，这是临床上获得最佳缓解率、最长生存以及最小毒副反应的最佳方法。目前我们有一些已经获批的并经指南推荐的标志基因，包括EGFR突变基因以及ALK重组基因。而且现在还有一些没有获得批准的标志物也正在进行临床试验研究。

　　临床上基因组学药物的优势是什么？

　　Celine Mascaux：这类药物的优势非常明显，患者不仅可以获得个体化的更有效的治疗方案，而且这类药物大多是采用口服的方式，患者完全可以在家中进行治疗而不必在医院进行静脉输液。当然，口服药物的毒副反应也相对小很多。

　　当今世界各地的分子检测水平是否存在一定的差异？您可以介绍一下欧洲基因组学研究现状吗？

　　Celine Mascaux：是的，这些差异主要是来自经济水平以及不同人种的基因突变频率。例如，东南亚人群EGFR基因的突变频率要高于白人，因此，我们需要根据人群基因的突变率选择最合适的检测基因类型。经济因素也是很重要的一个方面，有的患者经济条件较好，能够负担更先进的分子检测技术。

　　关于欧洲现在的基因组学研究主要包括两个方面：①基础研究，研究不同的肿瘤细胞和亚型可以帮助我们发现新的突变基因和治疗靶点，而这些靶点能带来新的治疗药物；②临床研究方面，包括评估第二代分子靶向药物的I、II期临床研究以及比较基因组学药物与标准化疗药物疗效的III期研究。

访谈原文:

　　<Oncology Frontier>: Genomics research is one of the hot topics nowadays， do you have any unique opinions about it?

　　Dr Celine:  Well that’s the future of how we will treat our patients. Now we need to use genomic medicine to find out about the markers and help us determine best treatment for patients and that’s how we’re now hoping and are succeeding to have better response and less toxicity.

　　<Oncology Frontier>:  Do you think it is necessary to classify patients according to genomics in clinical trials， and why?

　　Dr Celine:  It’s mandatory. This is how we can have the appropriate treatment for them. It’s the best way to have the best survival， the best response， and the lower toxicity of course. Yeah， it’s mandatory.

　　<Oncology Frontier>: What are common strategies for identifying genomic subsets in the clinic?

　　Dr Celine: So we have markers for which we have treatment that are approved and recommended， so for such abnormalities including the GFR mutation and ALK rearrangement， there are recommendations worldwide that exist for testing those markers and afterwards， when you are going into markers for which there is no approved treatment， this is made in the context of clinical trials.

　　<Oncology Frontier>:  What are their advantages and disadvantages?

　　Dr Celine: I don’t see any disadvantage to be honest. I see only advantages: the treatment that the patients receive are more specific， more efficient. It is easier to take because these are oral treatment， so they can take it home instead of taking IV profusion in hospitals. It has less toxicity， so I don’t see any problem with it. I see only advantages.

　　<Oncology Frontier>: Are there currently any differences in strategies for identifying genomics worldwide?

　　Dr Celine: Well， yeah， there are differences based on funding mainly， and also ethnical differences between those abnormalities that are frequent there. For example， more frequent GFR mutation in South Asian population than in Caucasian population， so the screening needs to be widely done in populations where there is more expectation to find it. But there is an economical reason to it， because some people have better access to the technology than others.

　　<Oncology Frontier>: And then lastly if you could just give a brief description of the types of genomics research going on in Europe right now?

　　Dr Celine: Types of research? Oh wow. Well， there’s basic research on cell lines or modes where we can try to find to identify new abnormalities that are not known so far and that are not targetable so far that would be. The new targets for the future for which there will be new treatment， this is basic research. And there is clinical research where we’re testing strategies where we are doing new generation sequencing， finding the targets and then giving specific treatment to the patients in the context of phase I and/or entry phase II trials， for testing these approaches and comparing them to the standards and the non-genomic treatment.