T790M突变的非小细胞肺癌研究现状与前景
发布时间：2018-07-17 20:49
【摘要】：目前,针对表皮生长因子受体(epidermal growth factor receptor,EGFR)突变的非小细胞肺癌(nonsmall cell lung cancer,NSCLC)公认的一线治疗方案是以EGFR酪氨酸激酶抑制剂(tyrosine kinase inhibitors,TKIs)为主的靶向治疗,尽管一代、二代TKIs带来的靶向治疗可为患者带来更长的无进展生存(progression-free survival,PFS),及更好的耐受,但其远期治疗不可避免会出现耐药。其中,50%以上的获得性耐药与T790M突变有关,因此美国国立综合癌症网络(National Comprehensive Cancer Network,NCCN)推出的最新指南已经提出三代TKI(Osimertinib,奥西替尼)可用于一线TKI治疗进展同时检出T790M突变的患者。但就在三代TKI为我们带来令人鼓舞的可长达13个月的中位PFS及延续着后EGFR-TKIs治疗时代的同时,也面临着严峻的挑战,如怎样实现T790M的检测及动态监测、对已有三代TKI的研究进展、出现三代TKI耐药的机制及后续治疗等,本文将围绕以上各热点问题展开综述。
[Abstract]:At present, the well-recognized first-line therapy for (epidermal growth factor receptor mutation in non-small cell lung cancer (NSCLC) is targeted at EGFR tyrosine kinase inhibitor (tyrosine kinase inhibitors (TKIs), although for a generation, The target therapy of second generation TKIs can bring about longer progression-free survival and better tolerance, but drug resistance is inevitable in the long term treatment of TKIs. More than 50% of acquired drug resistance is associated with T790M mutation. Therefore, the latest guidelines from the National Comprehensive Cancer Network (NCCN) have proposed that the third generation of TKI (Osimertinib) can be used to detect T790M mutation in first-line TKI patients at the same time. However, while the third generation of TKI has brought us an encouraging median PFS of 13 months and continues the post-EGFR-TKIs treatment era, it is also facing severe challenges, such as how to realize the detection and dynamic monitoring of T790M, and the research progress of three generations of TKIs. The mechanism of three generation TKI resistance and its follow-up treatment will be reviewed in this paper.
【作者单位】： 河北医科大学第四医院肿瘤内科;
【分类号】：R734.2
本文编号：2130893
[Abstract]:At present, the well-recognized first-line therapy for (epidermal growth factor receptor mutation in non-small cell lung cancer (NSCLC) is targeted at EGFR tyrosine kinase inhibitor (tyrosine kinase inhibitors (TKIs), although for a generation, The target therapy of second generation TKIs can bring about longer progression-free survival and better tolerance, but drug resistance is inevitable in the long term treatment of TKIs. More than 50% of acquired drug resistance is associated with T790M mutation. Therefore, the latest guidelines from the National Comprehensive Cancer Network (NCCN) have proposed that the third generation of TKI (Osimertinib) can be used to detect T790M mutation in first-line TKI patients at the same time. However, while the third generation of TKI has brought us an encouraging median PFS of 13 months and continues the post-EGFR-TKIs treatment era, it is also facing severe challenges, such as how to realize the detection and dynamic monitoring of T790M, and the research progress of three generations of TKIs. The mechanism of three generation TKI resistance and its follow-up treatment will be reviewed in this paper.
【作者单位】： 河北医科大学第四医院肿瘤内科;
【分类号】：R734.2
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