{"id":23528,"date":"2023-04-19T13:18:53","date_gmt":"2023-04-19T06:18:53","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=23528"},"modified":"2023-04-19T14:41:53","modified_gmt":"2023-04-19T07:41:53","slug":"duoc-di-truyen-hoc-trong-dieu-tri-ung-thu-phoi","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/duoc-di-truyen-hoc-trong-dieu-tri-ung-thu-phoi\/","title":{"rendered":"D\u01b0\u1ee3c Di Truy\u1ec1n H\u1ecdc Trong \u0110i\u1ec1u Tr\u1ecb Ung Th\u01b0 Ph\u1ed5i"},"content":{"rendered":"<p><a href=\"https:\/\/vinmec.com\/vi\/ung-buou-xa-tri\/thong-tin-suc-khoe\/5-dau-hieu-som-cua-ung-thu-phoi-ban-can-biet\/\">Ung th\u01b0 ph\u1ed5i<\/a> l\u00e0 m\u1ed9t trong nh\u1eefng lo\u1ea1i ung th\u01b0 ph\u1ed5 bi\u1ebfn nh\u1ea5t tr\u00ean to\u00e0n th\u1ebf gi\u1edbi. T\u1ef7 l\u1ec7 t\u1eed vong cao c\u1ee7a ung th\u01b0 ph\u1ed5i khi\u1ebfn c\u00e1c ph\u01b0\u01a1ng th\u1ee9c \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 tr\u1edf n\u00ean v\u00f4 c\u00f9ng c\u1ea7n thi\u1ebft.\u00a0D\u01b0\u1ee3c di truy\u1ec1n h\u1ecdc (pharmacogenomics) l\u00e0 m\u1ed9t l\u0129nh v\u1ef1c m\u1edbi t\u1eadp trung v\u00e0o c\u00e1ch c\u00e1c bi\u1ebfn th\u1ec3 di truy\u1ec1n \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn \u0111\u00e1p \u1ee9ng c\u1ee7a m\u1ed9t b\u1ec7nh nh\u00e2n v\u1edbi thu\u1ed1c. Trong tr\u01b0\u1eddng h\u1ee3p ung th\u01b0 ph\u1ed5i, hi\u1ec3u v\u00e0 \u00e1p d\u1ee5ng d\u01b0\u1ee3c di truy\u1ec1n h\u1ecdc c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn c\u00e1c l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 d\u1eabn t\u1edbi k\u1ebft qu\u1ea3 b\u1ec7nh nh\u00e2n t\u1ed1t h\u01a1n.<\/p>\n<ol>\n<li>\n<h2><strong>C\u01a1 s\u1edf l\u00fd lu\u1eadn c\u1ee7a vi\u1ec7c \u00e1p d\u1ee5ng d\u01b0\u1ee3c di truy\u1ec1n h\u1ecdc trong ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb ung th\u01b0<\/strong><\/h2>\n<\/li>\n<\/ol>\n<p>D\u01b0\u1ee3c di truy\u1ec1n h\u1ecdc l\u00e0 nghi\u00ean c\u1ee9u v\u1ec1 c\u00e1ch c\u1ea5u tr\u00fac di truy\u1ec1n c\u1ee7a m\u1ed9t c\u00e1 nh\u00e2n \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ph\u1ea3n \u1ee9ng c\u1ee7a h\u1ecd v\u1edbi thu\u1ed1c. M\u1ee5c ti\u00eau c\u1ee7a d\u01b0\u1ee3c l\u00fd h\u1ecdc l\u00e0 x\u00e1c \u0111\u1ecbnh c\u00e1c bi\u1ebfn th\u1ec3 di truy\u1ec1n c\u00f3 th\u1ec3 d\u1ef1 \u0111o\u00e1n ph\u1ea3n \u1ee9ng c\u1ee7a m\u1ed9t c\u00e1 nh\u00e2n \u0111\u1ed1i v\u1edbi m\u1ed9t lo\u1ea1i thu\u1ed1c c\u1ee5 th\u1ec3. Th\u00f4ng tin n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 c\u00e1 nh\u00e2n h\u00f3a c\u00e1c k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb, d\u1eabn \u0111\u1ebfn k\u1ebft qu\u1ea3 t\u1ed1t h\u01a1n v\u00e0 \u00edt t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c h\u01a1n. Trong tr\u01b0\u1eddng h\u1ee3p ung th\u01b0 ph\u1ed5i, d\u01b0\u1ee3c l\u00fd h\u1ecdc c\u00f3 th\u1ec3 gi\u00fap x\u00e1c \u0111\u1ecbnh c\u00e1c li\u1ec7u ph\u00e1p nh\u1eafm m\u1ee5c ti\u00eau c\u00f3 kh\u1ea3 n\u0103ng hi\u1ec7u qu\u1ea3 h\u01a1n \u0111\u1ed1i v\u1edbi m\u1ed9t b\u1ec7nh nh\u00e2n c\u1ee5 th\u1ec3. C\u00e1ch ti\u1ebfp c\u1eadn n\u00e0y c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn c\u00e1c l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb c\u00e1 nh\u00e2n h\u00f3a v\u00e0 hi\u1ec7u qu\u1ea3 h\u01a1n cho b\u1ec7nh nh\u00e2n ung th\u01b0 ph\u1ed5i.<\/p>\n<figure id=\"attachment_23534\" aria-describedby=\"caption-attachment-23534\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-23534\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-2023-04-17-175033-300x128.png\" alt=\"\" width=\"300\" height=\"128\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-2023-04-17-175033-300x128.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-2023-04-17-175033-1024x438.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-2023-04-17-175033-768x328.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-2023-04-17-175033.png 1273w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-23534\" class=\"wp-caption-text\">D\u01b0\u1ee3c di tuy\u1ec1n h\u1ecdc- B\u01b0\u1edbc ti\u1ebfn trong \u0111i\u1ec1u tr\u1ecb c\u00e1 nh\u00e2n h\u00f3a<\/figcaption><\/figure>\n<ol start=\"2\">\n<li>\n<h2><strong>Bi\u1ebfn \u0111\u1ed5i di truy\u1ec1n v\u00e0 thay \u0111\u1ed5i bi\u1ec3u sinh trong ung th\u01b0 ph\u1ed5i<\/strong><\/h2>\n<\/li>\n<\/ol>\n<p><em>Con \u0111\u01b0\u1eddng t\u00edn hi\u1ec7u EGFR \/ HER2 \/ MET:<\/em><\/p>\n<ul>\n<li>EGFR \u0111\u01b0\u1ee3c bi\u1ec3u hi\u1ec7n qu\u00e1 m\u1ee9c ho\u1eb7c k\u00edch ho\u1ea1t b\u1ea5t th\u01b0\u1eddng \u1edf h\u01a1n 60% ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf (NSCLC), v\u1edbi \u0111\u1ed9t bi\u1ebfn EGFR xu\u1ea5t hi\u1ec7n trong 10% \u0111\u1ebfn 40% NSCLC, t\u01b0\u01a1ng quan ch\u1eb7t ch\u1ebd v\u1edbi \u0111\u1ed9 nh\u1ea1y v\u1edbi c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf tyrosine kinase (EGFR TKIs), nh\u00f3m \u00a0kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng v\u00e0 TKI ph\u00e2n t\u1eed nh\u1ecf.<\/li>\n<li>S\u1ef1 khu\u1ebfch \u0111\u1ea1i MET \u0111ang l\u00e0 \u0111\u00edch t\u00e1c \u0111\u1ed9ng trong c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng v\u1edbi nhi\u1ec1u lo\u1ea1i kh\u00e1ng th\u1ec3 v\u00e0 ch\u1ea5t \u1ee9c ch\u1ebf ph\u00e2n t\u1eed nh\u1ecf, bao g\u1ed3m crizotinib. Khu\u1ebfch \u0111\u1ea1i MET c\u0169ng li\u00ean quan t\u1edbi s\u1ef1 kh\u00e1ng EGFR TKI, \u0111\u1ed9c l\u1eadp v\u1edbi T790M, b\u1eb1ng c\u00e1ch k\u00edch ho\u1ea1t con \u0111\u01b0\u1eddng PI3K \/ AKT \/mTOR.<\/li>\n<li>HER2 \u0111\u01b0\u1ee3c bi\u1ec3u hi\u1ec7n qu\u00e1 m\u1ee9c ho\u1eb7c khu\u1ebfch \u0111\u1ea1i trong m\u1ed9t t\u1ef7 l\u1ec7 \u0111\u00e1ng k\u1ec3 c\u00e1c tr\u01b0\u1eddng h\u1ee3p NSCLC. \u00a0\u00a0S\u1ef1 khu\u1ebfch \u0111\u1ea1i ho\u1eb7c bi\u1ec3u hi\u1ec7n qu\u00e1 m\u1ee9c c\u1ee7a HER2 kh\u00f4ng l\u00e0m t\u0103ng \u0111\u1ed9 nh\u1ea1y c\u1ea3m v\u1edbi \u00a0kh\u00e1ng th\u1ec3 HER2 \u00a0ho\u1eb7c \u00a0TKI \u00a0trong NSCLC \u00a0trong khi \u0111\u1ed9t bi\u1ebfn HER2 \u00a0c\u00f3 li\u00ean quan \u0111\u1ebfn kh\u1ea3 n\u0103ng kh\u00e1ng \u00a0EGFR TKI b\u1ea5t k\u1ec3\u00a0 t\u00ecnh tr\u1ea1ng \u0111\u1ed9t bi\u1ebfn EGFR c\u1ee7a b\u1ec7nh nh\u00e2n<\/li>\n<\/ul>\n<p><em>\u0110\u01b0\u1eddng d\u1eabn t\u00edn hi\u1ec7u RAS \/ RAF \/ MAPK:<\/em><\/p>\n<ul>\n<li>\u0110\u1ed9t bi\u1ebfn KRAS, th\u01b0\u1eddng \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y trong ung th\u01b0 ph\u1ed5i, kh\u00e1ng EGFR TKI v\u00e0 \u00a0\u0111\u1ed9c l\u1eadp v\u1edbi t\u00edn hi\u1ec7u EGFR. Hi\u1ec7n c\u00e1c nghi\u00ean c\u1ee9u \u0111\u1ec3 s\u1eed d\u1ee5ng KRAS nh\u01b0 \u0111\u00edch t\u00e1c \u0111\u1ed9ng \u0111\u1ec1u ch\u01b0a th\u00e0nh c\u00f4ng v\u1ec1 m\u1eb7t \u0111i\u1ec1u tr\u1ecb.<\/li>\n<li>BRAF \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y ch\u1ee7 y\u1ebfu \u00a0\u1edf \u00a0nh\u1eefng ng\u01b0\u1eddi h\u00fat thu\u1ed1c hi\u1ec7n t\u1ea1i \/ tr\u01b0\u1edbc \u0111\u00e2y \u00a0v\u00e0 ho\u1ea1t \u0111\u1ed9ng kinase c\u1ee7a n\u00f3 \u00a0c\u00f3 th\u1ec3 b\u1ecb \u1ee9c ch\u1ebf v\u1edbi c\u00e1c TKI ph\u00e2n t\u1eed nh\u1ecf nh\u01b0 dabrafenib v\u00e0 trametinib.<\/li>\n<\/ul>\n<p><em>Con \u0111\u01b0\u1eddng Pl3K \/ AKT \/ mTOR<\/em><\/p>\n<ul>\n<li>\u0110\u1ed9t bi\u1ebfn \u0111i\u1ec3m trong RAF MEK x\u1ea3y ra \u1edf m\u1ed9t t\u1ef7 l\u1ec7 nh\u1ecf NSCLC, g\u00e2y ra qu\u00e1 tr\u00ecnh phosphoryl h\u00f3a kinase. Tuy nhi\u00ean v\u1eabn ch\u01b0a x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c li\u1ec7u nh\u1eefng \u0111\u1ed9t bi\u1ebfn n\u00e0y c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng \u0111\u1ec3 l\u00e0m \u0111\u00edch t\u00e1c \u0111\u1ed9ng cho c\u00e1c thu\u1ed1c hay kh\u00f4ng.<\/li>\n<li>MYC c\u00f3 th\u1ec3 th\u00fac \u0111\u1ea9y t\u00e2n sinh th\u00f4ng qua bi\u1ec3u hi\u1ec7n\u00a0 v\u00e0 khu\u1ebfch \u0111\u1ea1i gen. Trong khi c\u00e1c m\u00f4 h\u00ecnh ti\u1ec1n l\u00e2m s\u00e0ng \u00a0\u0111\u00e3 ch\u1ec9 ra r\u1eb1ng \u00a0MYC c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng l\u00e0m \u0111\u00edch t\u00e1c \u0111\u1ed9ng c\u1ee7a c\u00e1c TKI ph\u00e2n t\u1eed nh\u1ecf, nh\u01b0ng hi\u1ec7n t\u1ea1i kh\u00f4ng c\u00f3 thu\u1ed1c t\u00e1c \u0111\u1ed9ng t\u1edbi MYC \u00a0trong c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng giai \u0111o\u1ea1n \u0111\u1ea7u.<\/li>\n<\/ul>\n<p><em>Con \u0111\u01b0\u1eddng PI3K \/ AKT \/ mTOR<\/em><\/p>\n<ul>\n<li>K\u00edch ho\u1ea1t con \u0111\u01b0\u1eddng PI3K \/ AKT \/ mTOR trong ung th\u01b0 ph\u1ed5i x\u1ea3y ra th\u00f4ng qua s\u1ef1 li\u00ean k\u1ebft c\u1ee7a c\u00e1c y\u1ebfu t\u1ed1 t\u0103ng tr\u01b0\u1edfng v\u1edbi RTK t\u01b0\u01a1ng \u1ee9ng c\u1ee7a ch\u00fang ho\u1eb7c m\u1ea5t ch\u1ee9c n\u0103ng c\u1ee7a TSG, v\u00e0 m\u1eb7c d\u00f9 c\u00f3 nhi\u1ec1u th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng, hi\u1ec7n t\u1ea1i kh\u00f4ng c\u00f3 li\u1ec7u ph\u00e1p nh\u1eafm m\u1ee5c ti\u00eau n\u00e0o cho con \u0111\u01b0\u1eddng n\u00e0y \u0111\u00e3 cho th\u1ea5y l\u1ee3i \u00edch l\u00e2m s\u00e0ng trong ung th\u01b0 ph\u1ed5i<\/li>\n<li>\u0110\u1ed9t bi\u1ebfn STK11 th\u01b0\u1eddng t\u01b0\u01a1ng quan v\u1edbi ho\u1ea1t h\u00f3a KRAS,\u00a0 t\u0103ng \u0111\u1ed9 nh\u1ea1y c\u1ea3m trong \u1ed1ng \u00a0nghi\u1ec7m v\u1edbi ch\u1ea5t \u1ee9c ch\u1ebf MEK, v\u00e0 s\u1ef1 k\u1ebft h\u1ee3p c\u1ee7a \u00a0\u0111\u1ed9t bi\u1ebfn STK11 v\u00e0 KRAS trong ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o tuy\u1ebfn (LUAC) g\u00e2y ti\u00ean l\u01b0\u1ee3ng x\u1ea5u v\u1edbi suy gi\u1ea3m mi\u1ec5n d\u1ecbch.<\/li>\n<\/ul>\n<p><em>Con \u0111\u01b0\u1eddng IGF<\/em><\/p>\n<ul>\n<li>Bi\u1ec3u hi\u1ec7n qu\u00e1 m\u1ee9c c\u1ee7a IGF1R trong NSCLC, \u0111\u1eb7c bi\u1ec7t l\u00e0 ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o v\u1ea3y (LUSC), th\u00fac \u0111\u1ea9y s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a kh\u1ed1i u v\u00e0 kh\u00e1ng thu\u1ed1c, nh\u01b0ng c\u00e1c nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng v\u1ec1 c\u00e1c thu\u1ed1c ch\u1ed1ng IGFR1 trong ph\u1ed5i v\u00e0 c\u00e1c b\u1ec7nh ung th\u01b0 kh\u00e1c \u0111\u00e3 t\u1ea1m d\u1eebng do \u0111\u1ed9c t\u00ednh qu\u00e1 m\u1ee9c.<\/li>\n<\/ul>\n<p><em>Con \u0111\u01b0\u1eddng FGF<\/em><\/p>\n<ul>\n<li>S\u1ef1 khu\u1ebfch \u0111\u1ea1i FGFR1 c\u00f3 li\u00ean quan \u0111\u1ebfn h\u00fat thu\u1ed1c l\u00e1 v\u00e0 t\u1ec9 l\u1ec7 s\u1ed1ng s\u00f3t th\u1ea5p. C\u00e1c ch\u1ea5t \u1ee9c ch\u1ebf ch\u1ed1ng FGFR \u0111\u00e3 cho th\u1ea5y ho\u1ea1t \u0111\u1ed9ng in vitro trong c\u00e1c d\u00f2ng t\u1ebf b\u00e0o \u0111\u1ed9t bi\u1ebfn FGFR, v\u1edbi nintedanib \u0111\u01b0\u1ee3c ch\u1ea5p thu\u1eadn s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb LUAC \u1edf ch\u00e2u \u00c2u.<\/li>\n<\/ul>\n<p><em>Con \u0111\u01b0\u1eddng P53<\/em><\/p>\n<ul>\n<li>TP53 l\u00e0 gen b\u1ecb thay \u0111\u1ed5i ph\u1ed5 bi\u1ebfn nh\u1ea5t trong ung th\u01b0 ph\u1ed5i, \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y trong h\u01a1n 90% SCLC v\u00e0 h\u01a1n 50% NSCLC. \u0110\u1ed9t bi\u1ebfn TP53 \u00a0ch\u01b0a th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng l\u00e0m \u0111\u00edch t\u00e1c \u0111\u1ed9ng trong \u0111i\u1ec1u tr\u1ecb nh\u01b0ng \u0111\u00e3 c\u00f3 nh\u1eefng n\u1ed7 l\u1ef1c \u0111ang \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ec3 kh\u00f4i ph\u1ee5c ch\u1ee9c n\u0103ng p53 b\u00ecnh th\u01b0\u1eddng ho\u1eb7c \u1ee9c ch\u1ebf protein \u0111\u1ed9t bi\u1ebfn,\u00a0 bao g\u1ed3m \u1ee9c ch\u1ebf c\u00e1c ch\u1ea5t \u0111i\u1ec1u h\u00f2a \u00e2m t\u00ednh c\u1ee7a v\u1eafc xin \u00a0P53, li\u1ec7u ph\u00e1p gen ho\u1eb7c c\u00e1c ph\u00e2n t\u1eed nh\u1ecf nh\u1eafm v\u00e0o protein \u0111\u1ed9t bi\u1ebfn.<\/li>\n<\/ul>\n<p><em>Protein dung h\u1ee3p (fusion protein)<\/em><\/p>\n<ul>\n<li>Protein dung h\u1ee3p ALK x\u1ea3y ra \u1edf 2% \u0111\u1ebfn 8% NSCLC, ch\u1ee7 y\u1ebfu \u1edf LUAC v\u00e0 c\u00e1c kh\u1ed1i u c\u00f3 dung h\u1ee3p ALK \u0111\u00e1p \u1ee9ng v\u1edbi c\u00e1c thu\u1ed1c c\u00f3 \u0111\u00edch t\u00e1c \u0111\u1ed9ng l\u00e0 ALK, \u0111\u01b0\u1ee3c ch\u1ea5p thu\u1eadn nh\u01b0 m\u1ed9t l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb \u0111\u1ea7u tay ho\u1eb7c th\u1ee9 hai.<\/li>\n<li>S\u1ef1 t\u00e1i s\u1eafp x\u1ebfp ROS1 x\u1ea3y ra \u1edf 1% \u0111\u1ebfn 2% b\u1ec7nh nh\u00e2n NSCLC, ch\u1ee7 y\u1ebfu l\u00e0 LUAC.<\/li>\n<li>S\u1ef1 t\u00e1i s\u1eafp x\u1ebfp RET x\u1ea3y ra \u1edf kho\u1ea3ng 1% \u0111\u1ebfn 2% NSCLC, ch\u1ee7 y\u1ebfu l\u00e0 LUAC. C\u00e1c ch\u1ea5t \u1ee9c ch\u1ebf ch\u1ecdn l\u1ecdc bi\u1ec3u hi\u1ec7n \u00edt \u0111\u1ed9c t\u00ednh h\u01a1n v\u00e0 \u0111ang \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 l\u00e2m s\u00e0ng.<\/li>\n<li>Dung h\u1ee3p NTRK \u0111\u01b0\u1ee3c \u01b0\u1edbc t\u00ednh x\u1ea3y ra \u1edf 3% NSCLC m\u00e0 kh\u00f4ng c\u00f3 \u0111\u1ed9t bi\u1ebfn n\u00e0o kh\u00e1c \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh, c\u00f3 th\u1ec3 khi\u1ebfn c\u00e1c kh\u1ed1i u kh\u00e1ng c\u00e1c ch\u1ea5t \u1ee9c ch\u1ebf TRK.<\/li>\n<li>Dung h\u1ee3p BRAF l\u00e0 c\u1ef1c k\u1ef3 hi\u1ebfm (0,2% NSCLC).<\/li>\n<li>Dung h\u1ee3p EGFR r\u1ea5t hi\u1ebfm, x\u1ea3y ra trong kho\u1ea3ng 0,05% ung th\u01b0 ph\u1ed5i v\u00e0 khi\u1ebfn c\u00e1c kh\u1ed1i u nh\u1ea1y c\u1ea3m EGFR TKIs.<\/li>\n<\/ul>\n<p><em>Thay \u0111\u1ed5i bi\u1ec3u sinh<\/em><\/p>\n<ul>\n<li>T\u0103ng methyl h\u00f3a v\u00e0 t\u00e1i c\u1ea5u tr\u00fac nhi\u1ec5m s\u1eafc th\u1ec3 c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn s\u1ef1 \u1ee9c ch\u1ebf phi\u00ean m\u00e3 c\u1ee7a c\u00e1c gen \u1ee9c ch\u1ebf kh\u1ed1i u (TSGs). C\u00e1c th\u1eed nghi\u1ec7m ban \u0111\u1ea7u v\u1edbi \u0111\u00edch t\u00e1c \u0111\u1ed9ng n\u00e0y c\u00f3 k\u1ebft qu\u1ea3 \u0111\u00e1ng th\u1ea5t v\u1ecdng, nh\u01b0ng vi\u1ec7c s\u1eed d\u1ee5ng li\u1ec1u th\u1ea5p h\u01a1n v\u00e0 k\u1ebft h\u1ee3p v\u1edbi c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb kh\u00e1c cho th\u1ea5y c\u00f3 l\u1ee3i \u00edch \u0111i\u1ec1u tr\u1ecb.<\/li>\n<li>C\u00e1c RNA kh\u00f4ng m\u00e3 h\u00f3a, bao g\u1ed3m miRNA v\u00e0 lncRNA, \u0111i\u1ec1u ch\u1ec9nh bi\u1ec3u hi\u1ec7n gen v\u00e0 g\u00f3p ph\u1ea7n v\u00e0o s\u1ef1 ph\u00e1t tri\u1ec3n, ti\u1ebfn tri\u1ec3n v\u00e0 di c\u0103n c\u1ee7a ung th\u01b0 ph\u1ed5i. C\u00f3 th\u1ec3 ph\u1ee5c h\u1ed3i c\u00e1c miRNA b\u1ea5t th\u01b0\u1eddng b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng c\u00e1c ch\u1ea5t b\u1eaft ch\u01b0\u1edbc ho\u1eb7c \u1ee9c ch\u1ebf miRNA. lncRNA c\u00f3 th\u1ec3 \u0111\u00f3ng vai tr\u00f2 l\u00e0 d\u1ea5u hi\u1ec7u ph\u00e2n t\u1eed x\u00e2m l\u1ea5n t\u1ed1i thi\u1ec3u \u0111\u1ec3 s\u00e0ng l\u1ecdc v\u00e0 ch\u1ea9n \u0111o\u00e1n, nh\u01b0ng kh\u00f4ng c\u00f3 li\u1ec7u ph\u00e1p n\u00e0o nh\u1eafm v\u00e0o s\u1ef1 thay \u0111\u1ed5i lncRNA.<\/li>\n<li>B\u1ea5t th\u01b0\u1eddng NFIB l\u00e0m t\u0103ng kh\u1ea3 n\u0103ng ti\u1ebfp c\u1eadn nhi\u1ec5m s\u1eafc th\u1ec3 v\u00e0 th\u00fac \u0111\u1ea9y di c\u0103n ung th\u01b0 ph\u1ed5i t\u1ebf b\u00e0o nh\u1ecf (SCLC).<\/li>\n<\/ul>\n<ol start=\"3\">\n<li>\n<h2><strong>C\u00e1c li\u1ec7u ph\u00e1p nh\u1eafm m\u1ee5c ti\u00eau \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00ea duy\u1ec7t cho ung th\u01b0 ph\u1ed5i<\/strong><\/h2>\n<\/li>\n<\/ol>\n<p><em>ALK<\/em><\/p>\n<ul>\n<li>Alectinib<\/li>\n<li>Brigatinib<\/li>\n<li>Ceritinib<\/li>\n<li>Crizotinib<\/li>\n<\/ul>\n<p><em>BRAF<\/em><\/p>\n<ul>\n<li>Dabrafenib<\/li>\n<li>Trametinib<\/li>\n<\/ul>\n<p><em>EGFR<\/em><\/p>\n<ul>\n<li>Afatinib<\/li>\n<li>Erlotinib<\/li>\n<li>Gefitinib<\/li>\n<li>Osimertinib<\/li>\n<\/ul>\n<p><em>FGFR<\/em><\/p>\n<ul>\n<li>Infigratinib<\/li>\n<\/ul>\n<p><em>HER3\/4<\/em><\/p>\n<ul>\n<li>Afatinib<\/li>\n<\/ul>\n<p>FGFR<\/p>\n<ul>\n<li>Crizotinib<\/li>\n<li>Capmatinib<\/li>\n<\/ul>\n<p><em>PD-1<\/em><\/p>\n<ul>\n<li>Pembrolizumab<\/li>\n<li>Nivolumab<\/li>\n<\/ul>\n<p><em>PDGFR<\/em><\/p>\n<ul>\n<li>Imatinib<\/li>\n<\/ul>\n<p><em>PDL1<\/em><\/p>\n<ul>\n<li>Atezolizumab<\/li>\n<li>Durvalumab<\/li>\n<\/ul>\n<p><em>ROS<\/em><\/p>\n<ul>\n<li>Crizotinib<\/li>\n<\/ul>\n<p><em>VEGF<\/em><\/p>\n<ul>\n<li>Bevacizumab<\/li>\n<\/ul>\n<p><em>VEGFR<\/em><\/p>\n<ul>\n<li>Alectinib<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Ung th\u01b0 ph\u1ed5i l\u00e0 m\u1ed9t trong nh\u1eefng lo\u1ea1i ung th\u01b0 ph\u1ed5 bi\u1ebfn nh\u1ea5t tr\u00ean to\u00e0n th\u1ebf gi\u1edbi. T\u1ef7 l\u1ec7 t\u1eed vong cao c\u1ee7a ung th\u01b0 ph\u1ed5i khi\u1ebfn c\u00e1c ph\u01b0\u01a1ng th\u1ee9c \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 tr\u1edf n\u00ean v\u00f4 c\u00f9ng c\u1ea7n thi\u1ebft.\u00a0D\u01b0\u1ee3c di truy\u1ec1n h\u1ecdc (pharmacogenomics) l\u00e0 m\u1ed9t l\u0129nh v\u1ef1c m\u1edbi t\u1eadp trung v\u00e0o c\u00e1ch c\u00e1c bi\u1ebfn [&hellip;]<\/p>\n","protected":false},"author":47,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[6,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>D\u01b0\u1ee3c Di Truy\u1ec1n H\u1ecdc Trong \u0110i\u1ec1u Tr\u1ecb Ung Th\u01b0 Ph\u1ed5i - Vinmec<\/title>\n<meta name=\"description\" content=\"D\u01b0\u1ee3c di truy\u1ec1n h\u1ecdc (pharmacogenomics) nghi\u00ean c\u1ee9u c\u00e1c bi\u1ebfn th\u1ec3 di truy\u1ec1n t\u1eeb \u0111\u00f3 g\u00f3p ph\u1ea7n \u0111\u01b0a ra c\u00e1c l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb ung th\u01b0 ph\u1ed5i hi\u1ec7u qu\u1ea3.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"D\u01b0\u1ee3c Di Truy\u1ec1n H\u1ecdc Trong \u0110i\u1ec1u Tr\u1ecb Ung Th\u01b0 Ph\u1ed5i - 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