| Abstract |
日本人の死因第1位を占める『がん』．なかでも肺がんは癌の死因の第1位であり，わが国においては年間7万人を超える患者が亡くなる．肺がん健診により早期発見の努力がなされてはいるが，診断時にその半数以上が遠隔転移を伴う手術不能の進行肺癌であり，全身状態が保たれていれば抗がん剤による薬物療法の適応となる．進行肺癌に対する薬物療法の治療成績は，20年前は平均生存期間が12〜15か月と極めて厳しいものであった...．しかし近年，遺伝子異常に基づく分子標的治療の導入により治療成績は著しく改善し，5年以上に渡り日常生活を維持できている症例も多く経験するようになっている．この肺癌治療の長足の進歩は優れた分子生物学的基礎研究の成果が礎となっていることは言うまでもな いが，質の高い医師主導臨床研究の積み重ねが治療成績向上に繋がったことは，この疾患領域においては特筆すべきことである．本稿においては，肺癌薬物治療が如何にして進歩してきたのか，その中で医師主導臨床研究がどのような役割を果たしてきたのかを，我々の研究の一端を含め紹介する．
‘‘Cancer‘‘ is the leading cause of death in Japan. Among them, lung cancer is the leading cause of cancer death, and more than 70,000 patients die annually in Japan. Despite of lung cancer medical examination in Japan, more than half of them are inoperable advanced lung cancer with distant metastasis at the time of diagnosis, and for those patients, treatment with anticancer drugs is indicated. The treatment outcome for advanced lung cancer was extremely severe 20 years ago, with a median survival time of 12-15 months. However, in recent years, the introduction of molecular-targeted therapy based on genetic abnormalities has significantly improved treatment results, and many cases have been experienced in which daily life can be maintained for more than 5 years. This long-term progress in lung cancer treatment is based on the results of excellent basic molecular biology research and it is also noteworthy that the accumulation of high-quality investigator-initiated clinical trials have led to improved treatment results. Here, I am going to introduce how lung cancer drug treatment has progressed and what role investigator-initiated clinical trials have played in it, including a part of our research.show more
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