摘要
肺癌是全球发生率和死亡率均位居首位的肿瘤相关疾病,非小细胞肺癌(NSCLC)占所有肺癌发病率中的80%以上,成为医学界关注最多的病理类型。国际肺癌研究协会、美国胸科学会和欧洲呼吸学会(IASLC/ATS/ERS)最早提出了NSCLC病理类型与表皮生长因子受体(EGFR)突变亚型存在千丝万缕的关系。多数EGFR突变型NSCLC对酪氨酸激酶抑制剂(TKIs)敏感,前期可以取得理想的治疗效果,然而后期往往发生耐药,使得治疗陷入困境。对于具有EGFR突变不同亚型的NSCLC患者在接受同一种EGFR-TKI治疗时存在疗效差异,这部分患者在接受第一代或第二代EGFR-TKI后也是均不可避免地产生耐药情况,甚至作为第三代EGFR-TKI代表奥西替尼的治疗仍不能完全满足临床的需求。因此,免疫检查点阻断剂(ICIs)成为了研究者竞相探索晚期EGFR突变NSCLC患者的治疗方案。本文旨在对晚期NSCLC的EGFR突变亚型及免疫检查点阻断治疗的研究进展作一全面综述。
Lung cancer is a tumor-related disease with the highest incidence and mortality in the world.Non-small cell lung cancer(NSCLC)accounts for more than 80%of all lung cancer incidence rates and it has become the most concerned pathology type in the medical community.The International Association for the Study of Lung Cancer,American Thoracic Society and the European Respiratory Society(IASLC/ATS/ERS)first proposed the inextricable relationship between the pathological type of NSCLC and the mutant subtype of epidermal growth factor receptor(EGFR).NSCLC patients with different subtypes of EGFR mutations are sensitive to tyrosine kinase inhibitors(TKIs)that exist when receiving the same EGFR-TKI treatment,and the ideal therapeutic effect can be achieved in the early stage,but subsequent resistance often occurs,which makes treatment difficult.Due to the difference in efficacy,these patients also have occurred drug resistance after receiving the first-generation or second-generation EGFR-TKI.Even the use of Osimertinib(the third-generation EGFR-TKI)still cannot greatly meet the clinical treatment needs.Therefore,immune checkpoint inhibitors(ICIs)have become a treatment options that researchers are competing to explore.This article aims to provide a comprehensive overview for the research progress of EGFR mutation subtypes and immune checkpoint blocking treatment in advanced NSCLC.
作者
吴柳盛
李小强
WU Liu-sheng;LI Xiao-qiang(Peking University Shenzhen Hospital,Clinical College of Anhui Medical University,Guangdong Province,Shenzhen518036,China;Department of Graduate School,Anhui Medical University,Anhui Province,Hefei230032,China;Department of Thoracic Surgery,Peking University Shenzhen Hospital,Guangdong Province,Shenzhen518036,China)
出处
《中国当代医药》
CAS
2021年第3期25-28,33,共5页
China Modern Medicine
基金
广东省医学科学技术研究基金项目(A2017327)
广东省深圳市科技计划资助项目(JCYJ20180228162607111)。
关键词
非小细胞肺癌
表皮生长因子受体
靶向治疗
酪氨酸激酶抑制剂
免疫检查点阻断剂
Non-small cell lung cancer
Epidermal growth factor receptor
Targeted therapy
Tyrosine kinase inhibitors
Immune checkpoint inhibitors
