Non-small-cell lung cancer (NSCLC) comprises approximately 85% of all lung cancer cases, often diagnosed at advanced stages, which diminishes the effective treatment options and survival rates. This systematic review assesses the utility of emerging biomarkers—circulating tumor DNA (ctDNA), microRNAs (miRNAs), and the blood tumor mutational burden (bTMB)—enhanced by next-generation sequencing (NGS) to improve the diagnostic accuracy, prognostic evaluation, and treatment strategies in NSCLC. Analyzing data from 37 studies involving 10,332 patients from 2020 to 2024, the review highlights how biomarkers like ctDNA and PD-L1 expression critically inform the selection of personalized therapies, particularly beneficial in the advanced stages of NSCLC. These biomarkers are critical for prognostic assessments and in dynamically adapting treatment plans, where high PD-L1 expression and specific genetic mutations (e.g., ALK fusions, EGFR mutations) significantly guide the use of targeted therapies and immunotherapies. The findings recommend integrating these biomarkers into standardized clinical pathways to maximize their potential in enhancing the treatment precision, ultimately fostering significant advancements in oncology and improving patient outcomes and quality of life. This review substantiates the prognostic and predictive value of these biomarkers and emphasizes the need for ongoing innovation in biomarker research.
非小细胞肺癌约占所有肺癌病例的85%，通常在晚期才被诊断，这限制了有效治疗选择并降低了生存率。本系统性综述评估了新一代测序技术强化的新兴生物标志物——循环肿瘤DNA、微小RNA及血液肿瘤突变负荷——在提升非小细胞肺癌诊断准确性、预后评估和治疗策略方面的效用。通过分析2020年至2024年间涉及10,332名患者的37项研究数据，本综述重点阐述了ctDNA和PD-L1表达等生物标志物如何为个体化治疗方案的选择提供关键信息，尤其在非小细胞肺癌晚期阶段具有重要价值。这些标志物对预后评估及治疗方案的动态调整至关重要，其中高PD-L1表达与特定基因突变（如ALK融合、EGFR突变）显著指导了靶向治疗和免疫疗法的应用。研究建议将这些生物标志物纳入标准化临床路径，以最大限度发挥其在提升治疗精准度方面的潜力，最终推动肿瘤学领域的重大进展，改善患者预后与生活质量。本综述证实了这些生物标志物的预后与预测价值，并强调需要持续推动生物标志物研究的创新。
肿瘤(癌症)患者之家