T790M突變的非小細(xì)胞肺癌研究現(xiàn)狀與前景
發(fā)布時(shí)間：2018-07-17 20:49
【摘要】：目前,針對(duì)表皮生長(zhǎng)因子受體(epidermal growth factor receptor,EGFR)突變的非小細(xì)胞肺癌(nonsmall cell lung cancer,NSCLC)公認(rèn)的一線治療方案是以EGFR酪氨酸激酶抑制劑(tyrosine kinase inhibitors,TKIs)為主的靶向治療,盡管一代、二代TKIs帶來的靶向治療可為患者帶來更長(zhǎng)的無進(jìn)展生存(progression-free survival,PFS),及更好的耐受,但其遠(yuǎn)期治療不可避免會(huì)出現(xiàn)耐藥。其中,50%以上的獲得性耐藥與T790M突變有關(guān),因此美國(guó)國(guó)立綜合癌癥網(wǎng)絡(luò)(National Comprehensive Cancer Network,NCCN)推出的最新指南已經(jīng)提出三代TKI(Osimertinib,奧西替尼)可用于一線TKI治療進(jìn)展同時(shí)檢出T790M突變的患者。但就在三代TKI為我們帶來令人鼓舞的可長(zhǎng)達(dá)13個(gè)月的中位PFS及延續(xù)著后EGFR-TKIs治療時(shí)代的同時(shí),也面臨著嚴(yán)峻的挑戰(zhàn),如怎樣實(shí)現(xiàn)T790M的檢測(cè)及動(dòng)態(tài)監(jiān)測(cè)、對(duì)已有三代TKI的研究進(jìn)展、出現(xiàn)三代TKI耐藥的機(jī)制及后續(xù)治療等,本文將圍繞以上各熱點(diǎn)問題展開綜述。
[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.
【作者單位】： 河北醫(yī)科大學(xué)第四醫(yī)院腫瘤內(nèi)科;
【分類號(hào)】：R734.2
本文編號(hào)：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.
【作者單位】： 河北醫(yī)科大學(xué)第四醫(yī)院腫瘤內(nèi)科;
【分類號(hào)】：R734.2
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