Recent advancements in oncology are shifting the paradigm of lung cancer management through the integration of precision medicine, expanded screening criteria, and targeted pharmacological interventions.

近期腫瘤學的進展透過整合精準醫療、擴大篩檢標準以及標靶藥物干預，正在改變肺癌管理的典範。

The historical reliance on smoking history as the primary determinant for screening eligibility is currently under critical re-evaluation. While low-dose computed tomography (LDCT) has demonstrated a significant reduction in mortality among heavy smokers, a substantial proportion of diagnosed patients—particularly women and those of Asian descent—do not meet existing US Preventive Services Task Force criteria. Consequently, there is a burgeoning academic movement toward 'sex-aware precision medicine,' acknowledging that biological sex influences carcinogen metabolism and genetic mutation patterns, such as the prevalence of EGFR and KRAS mutations in women. Furthermore, the emergence of lung cancer in non-smokers is now recognized as a biologically distinct entity, potentially driven by environmental factors including air pollution, radon exposure, and biomass fuel combustion.

過去將吸菸史視為篩檢資格主要決定因素的做法，目前正經過嚴格的重新評估。雖然低劑量電腦斷層掃描 (LDCT) 已證明能顯著降低重度吸菸者的死亡率，但仍有相當比例的診斷患者——尤其是女性與亞裔——不符合美國預防服務工作小組 (USPSTF) 的現行標準。因此，學術界正興起「性別意識精準醫療」的趨勢，承認生物學性別會影響致癌物代謝與基因突變模式，例如女性中 EGFR 與 KRAS 突變的盛行率。

Parallel to diagnostic shifts, therapeutic strategies have transitioned from generalized chemotherapy toward targeted molecular therapies. The development of tyrosine kinase inhibitors (TKIs) and antibody-drug conjugates, such as datopotamab deruxtecan, allows for the precise inhibition of proteins like ALK and TROP-2. Innovations in reversible bonding, exemplified by sevabertinib, aim to mitigate the emergence of drug resistance by preventing the mutation of binding sites. Additionally, the application of bispecific T-cell engagers (BiTEs) and the exploration of neoadjuvant immunotherapy have demonstrated improved overall survival rates in both non-small-cell and small-cell lung cancers.

與診斷轉移平行地，治療策略已從通用化學治療轉向標靶分子治療。酪氨酸激酶抑制劑 (TKI) 與抗體藥物複合體 (例如 datopotamab deruxtecan) 的開發，使得精確抑制 ALK 與 TROP-2 等蛋白質成為可能。以 sevabertinib 為代表的可逆結合創新技術，旨在透過防止結合位點突變來減輕藥物耐藥性的出現。此外，雙特異性 T 細胞接合器 (BiTEs) 的應用以及新輔助免疫治療的探索，已證明能提高非小細胞與小細胞肺癌的總體生存率。

Despite these technical strides, systemic disparities persist in the global distribution of care. Populations of African descent experience disproportionately late diagnoses and higher mortality rates, a phenomenon attributed to the scarcity of population-based cancer registries and the under-representation of these cohorts in clinical trials. The lack of genomic data specific to African ancestry has led to a reliance on extrapolation from European datasets, which may not account for distinct molecular profiles. Current efforts to rectify these imbalances include the implementation of equity-centered care models and the proposed establishment of a transcontinental consortium to standardize data collection and screening strategies across diverse geographies.

儘管有這些技術進步，全球醫療分佈仍存在系統性差異。非洲裔人群面臨不成比例的診斷延遲與較高死亡率，此現象歸因於缺乏基於人口的癌症登記系統，以及這些群體在臨床試驗中的代表性不足。缺乏針對非洲血統的基因組數據，導致依賴歐洲數據集的推論，而這可能無法解釋獨特的分子特徵。目前為糾正這些不平衡的努力包括實施以公平為中心的護理模式，以及建議建立一個跨洲聯盟，以在不同地理區域標準化數據收集與篩檢策略。

The field is moving toward a multi-modal approach that combines AI-driven risk assessment, sex-specific diagnostics, and targeted therapies to improve survival outcomes across all demographic cohorts.

該領域正朝向多模態方法發展，結合 AI 驅動的風險評估、性別特異性診斷與標靶治療，以提高所有人口群體的生存結果。