“美国非小细胞肺癌NCCN指南，该指南旨在给患者提供治疗信息，帮助患者从“0”到“1”认识肺癌，找到适合的治疗方案。本指南有些建议也许不适合你，你的医生可能会根据你的情况和其他因素制定不一样的治疗方案。”
本公众号将非小细胞肺癌NCCN指南重新整理拆分，将以中英文在公众号连载的方式发布，本指南不能做任何商业用途，转载请联系本公众号。
译者：朱志华、梅伟健
Part5.5 靶向治疗
靶向治疗是一系列的药物。它的工作原理是停止帮助癌细胞生长的关键分子。与化疗相比，它对正常细胞的伤害更小。针对肺癌的靶向治疗在指南6中列出。
Targeted therapy is a class of drugs. It works by stopping key molecules that help cancer cells grow. It is less likely to harm normal cells than chemotherapy. Targeted therapies for lung cancer are listed in Guide 6.
这些疗法会在接下来描述。这里列出了一些副作用。请您的治疗小组列出所有常见和罕见的副作用。在第7部分中，将提供关于谁应该收到这些药物的信息。靶向治疗通常是在某些突变出现的时候进行的。
These treatments are briefly described next. Some side effects are listed. Ask your treatment team for a full list of common and rare side effects. In Part 7,information on who should receive these drugs is provided. Targeted therapy is often given when certain mutations are present.
1、EGFR突变
细胞生长是由控制增长的信号介导的。EGFR是肺癌细胞表面受体之一，可以触发生长信号。一些患有肺癌患者有一些的基因突变,导致EGFR过度活跃。随着EGFR的过度活跃，新的癌细胞迅速形成。有5种药物用于阻止EGFRs引发生长信号。请参见图17所示。
Cell growth is started by growth signals. EGFR is one of the surface receptors in lung cancer cells that can trigger growth signals. Some people with lung cancer have gene mutations that cause EGFR to be overactive. With overactive EGFRs, new cancer cells form quickly. There are five medicines used to stop EGFRs from triggering growth signals. See Figure 17.
2、埃罗替尼
埃罗替尼与表皮生长因子受体的一部分连接，这部分是细胞内的一个组成部分。EGFR的这一部分是酪氨酸激酶。它是磷酸盐的一个对接地，因为它从一个分子移动到另一个分子。埃罗替尼阻断磷酸盐，阻止 EGFR完成它们的工作。因此，生长信号不是由EGFR 触发的。
Erlotinib attaches to a part of EGFR that is within cells. This part of EGFR is a tyrosine kinase. It is a docking site for phosphate as it is moved from one molecule to another. Erlotinib blocks phosphate and stops EGFRs from completing their job. Thus, growth signals aren’t triggered by EGFRs.
埃罗替尼是一种药丸。它应该是空腹服用的。剂量因人而异。你的医生会决定你需要的剂量。
Erlotinib is made as a pill. It should be taken on an empty stomach. The dose given differs among people. Your doctor will decide the dose you need.
埃罗替尼常见的副作用是皮疹、腹泻；不感到饥饿;虚弱；呼吸困难；和咳嗽。你可能有严重的眼睛，皮肤，肺，肾，或肝脏问题，但这些是罕见的。其他一些罕见的事件包括肠水肿和流血。如果你怀孕了，想要怀孕，或者哺乳，不要服用埃罗替尼。
Common side effects of erlotinib are rash; diarrhea; not feeling hungry; weakness; trouble breathing; and cough. You may have severe eye, skin, lung, kidney, or liver problems, but these are rare. Other rare events include tears in your gut and bleeding. Don’t take erlotinib if you are pregnant, trying to get pregnant, or breastfeeding.
3、吉非替尼
吉非替尼和埃罗替尼是相同类型的药物。吉非替尼是一种药丸。它可以与食物一起服用也可以不。通常是一天使用一次。
Gefitinib is the same type of drug as erlotinib. Gefitinib is made as a pill. It can be taken with or without food. It is usually taken once a day.
吉非替尼最常见的副作用是皮肤反应和腹泻。严重的副作用包括肠水肿和眼睛的问题。
The most common side effects of gefitinib are ski reactions and diarrhea. Serious side effects include a tear in your gut and eye problems.
很少有严重的肺和肝问题发生。不要在怀孕、想要怀孕或哺乳的情况下服用吉非替尼。
Very rarely, severe lung and liver problems occur. Don’t take gefitinib if pregnant, trying to get pregnant, or breastfeeding.
4、阿法替尼
阿法替尼和埃罗替尼是相同类型的药物。然而，它也阻止了另一种表面受体HER2。与埃罗替尼和吉非替尼不同，阿法替尼与EGFR和HER2不分离。它在细胞上的作用不会停止。
Afatinib is the same type of drug as erlotinib. However, it also stops another surface receptor called HER2. Unlike erlotinib and gefitinib, afatinib doesn’t detach from EGFR and HER2. Its effect on cells doesn’t stop.
阿法替尼被制作成药丸。它应该空腹服用。剂量因人而异。你的医生会决定你需要的剂量。
Afatinib is made as a pill. It should be taken on an empty stomach. The dose given differs among people. Your doctor will decide the dose you need.
阿法替尼常见的副作用包括腹泻、恶心、呕吐、皮疹 或干燥、*疮痤**、指甲感染、口腔溃疡、瘙痒、不感觉饿。腹泻和皮肤问题可能很严重。同样，你也可能有肺、肝、心脏和眼睛的问题。如果你怀孕了，想要怀孕，或者哺乳，不要服用阿法替尼。
Common side effects of afatinib include diarrhea, nausea, vomiting, skin rash or dryness, acne, nail infection, mouth sores, itching, and not feeling hungry. Diarrhea and skin problems may be severe. Likewise, you may also have lung, liver, heart, and eye problems. Don’t take afatinib if you are pregnant, trying to get pregnant, or breastfeeding.
5、奥斯替尼
奥斯替尼和埃罗替尼是相同类型的药物。它是一种药丸。它可以与食物一起服用，也可以不。剂量因人而异。你的医生会决定你需要的剂量。
Osimertinib is the same type of drug as erlotinib. It is made as a pill.It can be taken with or without food. The dose given differs among people.Your doctor will decide the dose you need.
奥斯替尼最常见的副作用是疲劳、腹泻、皮疹、皮肤干燥,指甲的变化。指甲的变化包括发红，肿胀，疼痛，指甲断裂和脱离。奥斯替尼也可能引起严重的眼、肺或心脏问题，但这些问题是罕见的。如果你怀孕或哺乳，奥斯替尼可能会伤害你的宝宝。
The most common side effects of osimertinib are tiredness, diarrhea, skin rash, dry skin, and nail changes. Nail changes include redness, swelling, pain, and nails breaking and detaching from the finge. Osimertinib may also cause severe eye, lung, or heart problems, but these problems are rare. Osimertinib may harm your baby if you’re pregnant or breastfeeding.
6、西妥昔单抗
西妥昔单抗连接到细胞外的EGFR分子末端。因此，其他分子(配体)被阻止附着在EGFR上。
Cetuximab attaches to the ends of EGFRs that are outside of the cell. Thus, molecules (ligands) are blocked from attaching to and turning on EGFRs.
即便没有任何增长信号。西妥昔单抗也能吸引免疫细胞来杀死癌细胞。
No growth signals are started. Cetuximab also attracts immune cells that help to kill the cancer cells.
当使用另一种EGFR靶向药物2癌症进展时可以考虑西 妥昔单抗与阿法替尼联合使用。它是通过注射的。通常每周或每隔一周一次。首次治疗可能需要2小时。后来的治疗只需要1个小时。
Cetuximab with afatinib may be received if the cancer worsens while taking another EGFR-targeted therapy. It is given by infusion. It is usually received once a week or every other week. It may take 2 hours to receive the first dose. Later doses will take only 1 hour.
西妥昔单抗常见的副作用是皮肤问题。这些问题包括*疮痤**样的皮疹，干燥的皮肤，眼睛炎症，和皮肤感染。其他常见的症状是腹泻和食欲不振。血镁含量可能下降。罕见但严重的副作用包括对输液的严重反应和肺损伤。如果你怀孕或哺乳，西妥昔单抗可能会伤害你的宝宝。
Common side effects of cetuximab are skin problems. These problems include acne-like rash, dry skin, eye inflammation, and skin infections. Other common side effects are diarrhea and loss of appetite. Blood magnesium levels may drop. Rare but serious side effects include a severe reaction to the infusion and lung damage. Cetuximab may harm your baby if you’re pregnant or breastfeeding.
7、ALK重组
ALK是一种可以引发肺癌细胞生长信号的表面受体。在ALK重组的肺癌中，ALK是活跃的。由于过度活跃的ALK，新的癌细胞迅速形成。有四种药物用于阻止ALK触发生长信号。
ALK is a surface receptor that can trigger growth signals in lung cancer cells. In lung cancers with an ALK rearrangement, ALK is overactive. With overactive ALK, new cancer cells form quickly. There are four medicines used to stop ALK from triggering growth signals.
8、克唑替尼
克唑替尼连接ALK的细胞内部分。ALK的这部分是酪氨酸激酶。它是磷酸盐的一个对接地，因为它从一个分子移动到另一个分子。克唑替尼阻断磷酸盐，阻断ALK信号。
Crizotinib attaches to a part of ALK that is within cells. This part of ALK is a tyrosine kinase. It is a docking site for phosphate as it is moved from one molecule to another. Crizotinib blocks the phosphate and stops ALK signaling.
克唑替尼制成药丸。每天两次。它可以与食物一起服用也可以不。
Crizotinib is made as a pill. It is taken twice a day. It can be taken with or without food.
克唑替尼常见的副作用包括视力问题；胃病(恶心、呕吐、腹泻、便秘)；不感到饥饿；水肿；尽管睡了，感觉很累。它会引起头晕、肺部感染和神经损伤。严重的副作用可能包括肺、肝和心脏问题。如果你在怀孕或哺乳期，它可能会伤害你的宝宝。
Common side effects of crizotinib include vision problems; stomach problems (nausea, vomiting, diarrhea, constipation); not feeling hungry; fluid buildup; and feeling tired despite sleep. It can cause dizziness, lung infections, and nerve damage. Severe problems may include lung, liver, and heart problems. Crizotinib may harm your baby if you’re pregnant or breastfeeding.
9、色瑞替尼
色瑞替尼是和克唑替尼相同类型的药物。然而，他们的结构不一样。因此，当克唑替尼不能起作用时，色瑞替尼能够阻止磷酸盐。
Ceritinib is the same type of drug as crizotinib. However, the structure of ceritinib differs from crizotinib. Thus, it is able to block phosphate when crizotinib can’t.
色瑞替尼被制成药丸。它应该是空腹服用的。然而，你的医生可能建议你吃点食物。一天一次。
Ceritinib is made as a pill. It should be taken on an empty stomach. However, your doctor may suggest a different dose with food. It is taken once a da .
色瑞替尼常见的副作用是腹泻、恶心、呕吐、腹痛、疲劳、不感觉饿，减肥。它很少导致严重的肺、心脏和肝脏 问题。如果你怀孕或哺乳，色瑞替尼可能会伤害你的宝宝。
Common side effects of ceritinib are diarrhea, nausea, vomiting, abdominal pain, tiredness, not feeling hungry, and weight loss. It rarely causes severe lung, heart, and liver problems. Ceritinib may harm your baby if you’re pregnant or breastfeeding.
10、阿雷替尼
阿雷替尼是与克唑替尼相同类型的药物。但是，它的结构是不一样的。因此，当克唑替尼不能起作用时，它能够阻止磷酸盐。
Alectinib is the same type of drug as crizotinib and ceritinib. However, its structure differs.Thus, it is able to block phosphate when other medicines do not.
阿雷替尼被制成药丸。每天用食物吃两次。常见的副作用是疲劳、便秘肿胀和肌肉疼痛。它很少导致严重的肺、心脏、肾脏和肝脏问题。如果你怀孕或哺乳的话，阿雷替尼可能会伤害你的宝宝。
Alectinib is made as a pill. It is taken twice a day with food. Common side effects of alectinib are tiredness, constipation, swelling, and muscle pain. It rarely causes severe lung, heart, kidney, and liver problems. Alectinib may harm your baby if you’re pregnant or breastfeeding.
11、布格替尼
布格替尼的作用与其他药物类似，但其结构不一样。因此，当其他药物没有用时，它能够阻止磷酸盐。布格替尼被制成药丸。它可以与食物一起服用，也可以不。一天一次。在治疗的第一周半剂量服用。常见副作用包括恶心、腹泻、头痛、咳嗽、和疲劳。它可能会导致严重的肺、心脏、视力和肌肉问题。如果你怀孕或哺乳的话，它可能会伤害你的宝宝。
Brigatinib works much like the other medicines but its structure differs.Thus, it is able to block phosphate when other medicines do not.Brigatinib is made as a pill. It can be taken with or without food. It is taken once a day. It is given at half dose for the first week of treatment Common side effects include nausea, diarrhea, headache, cough, and tiredness. It may cause severe lung, heart, vision, and muscle problems. Brigatinib may harm your baby if you’re pregnant or breastfeeding.
12、ROS1重组
ROS1是表面受体,可以引发肺癌细胞生长信号。在有ROS1重组的肺癌中，ROS1是过度活跃的。随着过度活跃的ROS1，新的癌细胞迅速形成。有两种药物用于阻止ROS1触发生长信号。
ROS1 is surface receptor that can trigger growth signals in lung cancer cells. In lung cancers with a ROS1 rearrangement, ROS1 is overactive. With overactive ROS1, new cancer cells form quickly. There are two medicines used to stop ROS1 from triggering growth signals.
13、色瑞替尼
除了ALK，色瑞替尼也能通过ROS1停止生长信号。它的作用是阻断酪氨酸激酶的磷酸转移。请阅读ALK重组的部分，了解更多关于色瑞替尼的信息。
Besides ALK, ceritinib also stops growth signals from ROS1. It works by blocking the transfer of phosphate by the tyrosine kinase. Read the section, ALK rearrangement, to learn more about ceritinib.
14、克唑替尼
除了ALK，克唑替尼也能通过ROS1停止生长信号。它的作用是阻断酪氨酸激酶的磷酸转移。请阅读ALK 重组的部分，了解更多关于克唑替尼的信息。
Besides ALK, crizotinib also stops growth signals from ROS1. It works by blocking the transfer of phosphate by the tyrosine kinase. Read the section, ALK rearrangement, to learn more about crizotinib.
15、BRAF V600E突变
BRAF是细胞内的激酶。它将磷酸盐从一个分子转移到另一个分子。磷酸盐能激发下一个增长的信号通路。在有BRAF V600E突变的肺癌中，BRAF过度活跃。随着过度活跃的BRAF，新的癌细胞迅速形成。有三种药物可以治疗过度活跃的BRAF信号。参见图18所示。
BRAF is a kinase inside of cells. It transfers phosphates from one molecule to another. The phosphate “turns on” the next growth signal in the pathway. In lung cancers with a BRAF V600E mutation, BRAF is overactive. With overactive BRAF, new cancer cells form quickly. There are three medicines to treat overactive BRAF signals. See Figure 18.
16、达拉非尼+曲美替尼
达拉非尼和曲美替尼最常联合用于治疗。达拉非尼附着在BRAF上，并阻止磷酸盐的转移。曲美替尼阻断了另一种叫MEK的激酶转移磷酸盐。BRAF和MEK在相同的生长信号通路中。MEK在这条通路上将会进一步下调。
Dabrafenib and trametinib are most often used together for treatment. Dabrafenib attaches to BRAF and blocks the transfer of phosphate. Trametinib blocks the transfer of phosphate by another kinase called MEK. BRAF and MEK are within the same growth signal pathway. MEK is further down in the pathway.
达拉非尼和曲美替尼被制成药丸。两者都应该空腹服用。达拉非尼每天要服两次。曲美替尼则在每天的同一时间服用一次。
Dabrafenib and trametinib are made as pills. Both should be taken on an empty stomach. Dabrafenib is taken twice a day. Trametinib is taken once a day at the same time each day.
常见的副作用包括发烧、发冷、和疲劳。你可能会感到恶心、呕吐、腹泻或不感到饥饿。你的皮肤会变得干燥或起疹子。你的脸、胳膊或腿可能会肿起来。出血、咳嗽和呼吸短促也很常见。
Common side effects of dabrafenib with trametinib include fever, chills, and fatigue. You may feel nauseated, vomit, have diarrhea, or not feel hungry. Your skin may become dry or get a rash. You face, arms, or legs may swell. Bleeding, cough, and shortness of breath are also common.
罕见但严重的副作用包括你的肠水肿，血栓，心脏，眼睛，或者肺部的问题。发烧、皮疹或出血可能是严重的。血糖可能会变得很高。其他类型的癌症可能会发展。
There are rare but serious side effects.These include tears in your gut, blood clots, and heart, eye, or lung problems. Fever, rash, or bleeding may be severe. Blood sugar may become very high. Other types of cancer may develop.
如果你想要一个孩子,告诉你的医生。你的精子数量会下降。妇女怀孕可能会有困难。如果你怀孕或哺乳，不要使用达拉非尼和曲美替尼。这些药可能会伤害你的孩子。
If you want to have a baby, tell your doctor. Sperm counts can drop in men. Women may have trouble getting pregnant. Don’t use dabrafenib and trametinib if you’re pregnant or breastfeeding. These medicines may harm your baby.
17、单独达拉非尼
达拉非尼和曲美替尼联用可能对你的身体损伤太大。在这种情况下，仅使用达拉非尼可能是一种选择。常见的副作用包括皮肤的变化。你的皮肤会变得很厚或长疣。你的手或脚可能会变成红色、肿胀、剥皮或感觉柔软。其他常见的副作用包括发烧、关节疼痛和脱发。
Dabrafenib and trametinib may be too hard on your body. In this case, dabrafenib used alone may be an option. Common side effects include changes in your skin. Your skin may become thick or get warts. Your hands or feet may become red, swell, peel, or feel tender. Other common side effects are feve, joint aches, and hair loss.
18、维罗非尼
如果达拉非尼+曲美替尼不能使用，维罗非尼也可能是一个选项。它像达拉非尼一样，停止了BRAF信号。它被用来治疗黑色素瘤。用于治疗肺癌则需要更多的研究。
Vemurafenib may also be an option if dabrafenib with trametinib can’t be taken. It works like dabrafenib and stops BRAF signals. It is used to treat melanoma. More research is needed on lung cancer.
维罗非尼制成药丸。每天两次。它可以与食物一起服用，也可以不。副作用对于黑素瘤和肺癌可能是相似的。
Vemurafenib is made as a pill. It is taken twice a day. It can be taken with or without food.
常见的黑色素瘤治疗副作用包括关节疼痛、疲劳和恶心。你的皮肤可能会有疹子或疣。你可能有脱发或容易被晒伤。你可能会感到痒。严重的方面包括过敏或皮肤反应，心脏问题，肝脏或肾脏损害，和眼睛问题。
Side effects may be alike for melanoma and lung cancer. Common side effects for melanoma treatment include joint pain, tiredness, and nausea. Your skin may get a rash or warts. You may have hair loss or easily get a sunburn. You may feel itchy. Serious side effects include allergic or skin reactions, heart problems, liver or kidney damage, and eye problems.
19、VEGF 通路
癌细胞需要血液中的食物和氧气以便生长。癌细胞从生长在肿瘤中的血管中获得血液。VEGF(血管内皮生长因子)是促使血管生长的分子之一。
Cancer cells need the food and oxygen in blood to grow. Cancer cells get blood from blood vessels that have grown into the tumor. VEGF (vascular endothelial growth factor) is one of the molecules that triggers the growth of these blood vessels.
不像其他的生物标志物，VEGF不是突变。然而，它在大多数肺癌中起作用。VEGF是由癌细胞产生的。它从癌细胞转移到内皮细胞。内皮细胞形成血管。
Unlike other biomarkers, VEGF is not mutated. However, it plays a role in most lung cancers. VEGF is made by cancer cells. It travels from cancer cells to endothelial cells. Endothelial cells form blood vessels.
VEGF与内皮细胞表面受体相结合。VEGF与表面受体的附着会触发生长信号。有两种药物用于阻止VEGF引起的生长信号。
VEGF attaches to surface receptors on the outside of endothelial cells. Attachment of VEGF to surface receptors triggers growth signals. There are two medicines used to stop the growth signals caused by VEGF.
20、贝伐单抗
贝伐单抗在VEGF与内皮细胞受体相连之前，现与VEGF结合。参见图19所示。因此，VEGF不能附着在受体上。VEGF没有引起生长信号。
Bevacizumab attaches to VEGF before it attaches to receptors on endothelial cells. See Figure 19. As a result, VEGF can’t attach to receptors. No growth signals caused by VEGF are started.
贝伐单抗是由输液完成的。首次治疗大约需要90分钟，之后大约需要30分钟。贝伐单抗通常会与化疗同时进行，4 - 6次治疗后则可以单独使用，以保持良好的效果。根据化疗方案的不同，每2或3周给予一次。
Bevacizumab is given by infusion. It takes about 90 minutes to get the first dose and 30 minutes for later doses. Bevacizumab is always first given with chemotherapy and after 4 to 6 treatments, may be given alone to maintain good results. It is given every 2 or 3 weeks depending on the chemotherapy.
常见副作用是高血压，流鼻血，头痛。你也可能有流鼻涕、尿蛋白和直肠出血。罕见但严重的副作用包括中风、心脏病、血凝块、肾脏损害、肠道内的裂口、身体部位的异常通道和出血。很少会出现脑损伤。如果你怀孕了，试着怀孕，或者哺乳，不要服用贝伐珠单抗。
Common side effects of bevacizumab are high blood pressure, nosebleeds, and headache. You might also have a runny nose, protein in the urine, and rectal bleeding. Rare but serious side effects include stroke, heart attack, blood clots, kidney damage, a tear in your gut, abnormal passage between body parts, and bleeding. Very rarely, brain damage occurs. Don’t take bevacizumab if you are pregnant, trying to get pregnant, or breastfeeding.
21、雷莫芦单抗
雷莫芦单抗与VEGF受体在细胞外结合。这阻止了VEGF的附着。VEGF没有引起生长信号。
Ramucirumab attaches to VEGF receptors on the outside of endothelial cells. This blocks VEGF from attaching. No growth signals caused by VEGF are started.
雷莫芦单抗由输液完成。需要60分钟才能得到全部剂量。它总是与化疗同时进行。每两周进行一次化疗。
Ramucirumab is given by infusion. It takes 60 minutes to receive the full dose. Ramucirumab is always given with chemotherapy. It is given every two weeks on the first day of chemotherap .
常见的副作用是高血压和腹泻。严重的方面包括出血、血块、内脏的水肿、身体部位的异常通道和缓慢的伤口愈合。很少会出现脑损伤。如果怀孕，尝试怀孕，或哺乳不要服用它。
Common side effects of ramucirumab are high blood pressure and diarrhea. Serious side effects include bleeding, blood clots, tears in your gut, abnormal passage between body parts, and slow wound healing. Very rarely, brain damage occurs. Don’t take bevacizumab if pregnant, trying to get pregnant, or breastfeeding.
22、其他靶向分子
虽然罕见,还有其他生物标记的肺癌的治疗。这些治疗方法被批准用于肺癌或其他癌症，但仍需要更多的研究。这种治疗方法包括针对HER2的ado -曲妥珠单抗。Cabozantinib和vandetanib针对RET。除了针对ALK和ROS1，克唑替尼也能针对MET。
Although rare, there are other biomarkers of lung cancer for which there are treatments. These treatments are approved for lung or other cancers but still need more research. Such treatments include ado-trastuzumab for HER2. Cabozantinib and vandetanib target RET. In addition to targeting ALK and ROS1, crizotinib targets MET.
23、补充和替代医学
CAM (补充和替代疗法)是一组医生很少给予的治疗。目前与很多人关注CAM对癌症的治疗。目前正在研究许多CAMs，看它们是否真的有用。
CAM (complementary and alternative medicine) is a group of treatments that aren’t often given by doctors. There is much interest today in CAM for cancer. Many CAMs are being studied to see if they are truly helpful.
辅助药物是与常见的医学治疗一起给予的治疗。虽然CAMs不能杀死癌细胞，但它们可以改善你的舒适和健康。两个例子是针灸治疗疼痛和瑜伽放松。
Complementary medicines are treatments given along with usual medical treatments. While CAMs aren’t known to kill cancer cells, they may improve your comfort and wellbeing. Two examples are acupuncture for pain management and yoga for relaxation.
替代医学用来替代常见的医学治疗。一些替代药物被出售用于治疗，尽管它们尚未被证明在 临床试验中有效。如果有充分的证据证明 CAMs或其他治疗方法治愈了癌症，他们将会被纳入这本书中。
Alternative medicine is used in place of usual medicine. Some alternative medicines are sold as cures even though they haven’t been proven to work in clinical trials. If there was good proof that CAMs or other treatments cured cancer, they would be included in this book.
如果你正在使用CAMs，告诉你的治疗团队是很重要的。他们可以告诉你哪些CAMs可能是有用的，哪些CAMs可能会限制药物治疗的效果。
It is important to tell your treatment team if you are using any CAMs. They can tell you which CAMs may be helpful and which CAMs may limit how well medical treatments work.
