晚期非小细胞肺癌患者个体化治疗的新突破

New approaches for individual treatment of advanced non-small cell lung cancer

在世界范围内,肺癌位居所有癌症致死的首位,且其中大部分为非小细胞肺癌。尽管大量有关含铂化疗或联合其他药物的临床研究不断涌现,非小细胞肺癌患者的预后仍然差强人意。晚期非小细胞肺癌患者的5年生存率约为15%,在过去几年中未有明显提高。目前,肺癌治疗领域的主要成就在于靶向治疗的出现,例如针对表皮细胞生长因子受体(EGFR)靶点的吉非替尼和厄罗替尼,以及针对抗血管内皮细胞生长因子(VEGF)的贝伐单抗,均广泛运用于临床。同时,关于棘皮动物微管相关蛋白样/间变淋巴瘤激酶(EML4-ALK)融合基因的研究使得肺癌的治疗又有了新的进展。该文主要对晚期非小细胞肺癌患者个体化治疗中的药物如EGFR抑制剂、EML4-ALK融合基因抑制剂进行综述。

Lung cancer continues to be the leading cause of cancer death worldwide,and non-small cell lung cancer is the most common type of lung cancer.Despite many clinical trials of platinum-based chemotherapy in combination with various drugs,the median survival time of patients with non-small cell lung cancer remains poor.The overall 5-year survival rate of patients with advanced non-small cell lung cancer is approximately 15%,and has improved only marginally in recent years.A recent milestone in this field has been the development of molecular-targeting drugs,among which gefitinib and erlotinib targeting the epidermal growth factor receptor(EGFR) have improved the efficacy of therapy for non-small cell lung cancer.Anti-angiogenetic drug,such as bevacizumab,has been used in the treatment of non-small cell lung cancer.Moreover,the discovery of echinoderm microtubule-associated protein-like 4/anaplastic lymphoma kinase(EML4-ALK) fusion gene has contributed to the marvelous progress in research of lung cancer.In this review,the drugs used in individualized treatment of advanced non-small cell lung cancer,such as EGFR-tyrosine kinase inhibitors and EML4-ALK fusion gene inhibitors are introduced.