EGFR突变晚期非小细胞肺癌患者免疫治疗的研究进展

Research progress of immunotherapy in epidermal growth factor receptor mutant advanced non-small cell lung cancer

靶向治疗和免疫治疗极大地改变了晚期非小细胞肺癌(NSCLC)的治疗模式,为广大患者带来了临床获益。酪氨酸激酶抑制剂是表皮生长因子受体(EGFR)突变NSCLC的标准治疗,但仍不可避免出现耐药。近几年来,免疫检查点抑制剂单药及联合治疗在晚期NSCLC一线及二线治疗中取得了突破性进展。然而,临床研究表明EGFR突变NSCLC患者接受免疫治疗的疗效不甚理想,此类患者是否能从免疫治疗中获益尚无定论。本文结合国内外最新研究进展,通过对EGFR信号通路的免疫调节作用、EGFR突变NSCLC免疫治疗的现状、EGFR突变NSCLC免疫检查点抑制剂的潜在耐药机制以及接受免疫检查点抑制剂的优势人群几个方面进行综述。

Targeted therapy and immunotherapy have greatly changed the treatment pattern of non-small cell lung cancer(NSCLC)and brought clinical benefits to many patients.Tyrosine kinase inhibitors(TKI)are the standard treatment for epidermal growth factor receptor(EGFR)mutant NSCLC.However,the development of drug resistance is inevitable.In recent years,monotherapy and combination therapy with immune chechpoint inhibitors(ICI)have made breakthrough progress in the first and secondline treatment of advanced NSCLC.Clinical studies have shown that the effect of immunotherapy on patients with EGFR-mutated NSCLC is not ideal.Whether such patients can benefit from immunotherapy is still inconclusive.In this review,we will summarize the latest research progress about the immunomodulatory effects which including EGFR signaling pathway,current research of immunotherapy for EGFR mutant NSCLC,the underlying mechanism of resistance to immune checkpoint inhibitors and the population who could possibly benefit from immune checkpoint inhibitors.