靶向基因疗法在阻止癌症方面非常有效，但治疗方法的丰富性、成本以及缓慢的变革正在阻碍患者获得这些疗法。
New Cancer Drugs Are Revolutionary. Why Don’t More Patients Get Them? Targeted gene therapies are highly effective at stopping cancers, but the very abundance of the treatments, plus cost and sluggish change, are hindering access.
约翰·埃伯斯与家人的滑雪之旅被一种压倒性的疲劳感破坏了。“我看着我的妻子，”他回忆道，“说：‘天哪，我需要变得更强壮。’”不到四周后，46岁的商业养蜂人埃伯斯先生得知问题比他的健康状况更严峻：一个肿瘤突破了结肠壁并扩散到淋巴结。他患有3期结直肠癌。
A crushing sense of fatigue was spoiling John Ebers’s ski trip with his family. “I looked at my wife,” he recalled, “and said, ‘Man, I need to get in better shape.’”Less than four weeks later, Mr. Ebers, a 46-year-old commercial beekeeper, learned the problem was something much grimmer than his fitness level: A tumor had broken through the wall of his colon and spread to his lymph nodes. He had Stage 3 colorectal cancer.
为了接受治疗，埃伯斯先生预约了密歇根州大急流城癌症与血液学中心的当地肿瘤科医生。他接受了化疗，正如该诊所的一位代表在电子邮件中指出的，这是标准治疗方案，尽管它常常使人虚弱。对埃伯斯先生来说，化疗几乎无法忍受。
In order to get treatment, Mr. Ebers made an appointment with a local oncologist at the Cancer & Hematology Centers in Grand Rapids, Mich. He was prescribed chemotherapy, which — as a representative for the practice noted in an email — is the standard of care, even though it is often debilitating. For Mr. Ebers, chemotherapy was nearly impossible to tolerate.
他没有被告知的是，还有另一种治疗途径可供他选择——一种从对癌症基因组成进行测序开始的途径。根据科罗拉多大学安舒茨癌症中心的克里斯托弗·刘博士的说法，基因检测可能揭示是否有药物可以精确攻击埃伯斯先生的癌症。靶向药物对于不想化疗或对化疗反应不良，或癌症已经扩散的患者尤为重要。
What he hadn’t been told was that there was another treatment route available to him — one that started with sequencing the cancer’s genetic makeup. Genetic testing, according to Dr. Christopher Lieu of the University of Colorado Anschutz Cancer Center, could have revealed whether there were drugs that could precisely attack Mr. Ebers’s cancer. Targeted drugs are especially important for patients who don’t want chemotherapy or react badly to it, or whose cancer has spread.
“如果埃伯斯先生进行了生物标志物检测，可能会引入新的、更有效的、可能毒性更小的疗法来治疗他的癌症，”刘博士说，他是倡导组织结直肠癌联盟的医学科学顾问。
“If Mr. Ebers had biomarker testing, it could have introduced new, more effective, and potentially less toxic, therapies to treat his cancer,” said Dr. Lieu, a medical scientific adviser to the Colorectal Cancer Alliance, an advocacy group.
这种情况太常见了。许多患者可能受益于能够禁用驱动其肿瘤的基因的新药。但医生没有将他们的肿瘤细胞送去检测，或者即使检测了，也没有开具这些药物。
It’s a situation that is all too common. Many patients could be helped by new drugs that disable the genes fueling their tumors. But doctors are not sending their tumor cells to be tested or, even if they are, prescribing the drugs.