非小细胞肺癌的分子靶向药物治疗

Molecular targets therapy for non-small cell lung cancer

肺癌是一种高发病率的肿瘤。目前已知表皮生长因子受体(EGFR)、血管内皮生长因子(VEGF)在非小细胞肺癌中有过表达,这种存在于肿瘤组织的过表达通过下游的信号传导能导致肿瘤细胞的增生、血管的生长,凋亡受抑制。表皮生长因子受体-酪氨酸激酶抑制剂(EGFR-TKI)通过抑制酪氨酸激酶,抗EGFR单克隆抗体通过和EGFR自身配体竞争受体及抗VEGF单克隆抗体通过和其形成复合物而阻断其信号通路的传导来达到控制肿瘤增生和发展的目的,仅有少许可耐受的不良反应。TKI对东方人NSCLC疗效,腺癌、不吸烟和女性的疗效好可能和其EGFR基因的高突变率相关。但其和化疗合用未显示增加化疗的效果。抗EGFR及VEGF单克隆抗体与化疗合用均显示了一定的效果。就非小细胞肺癌来说,靶向治疗已成为了另一种有效的全身治疗。

Lung cancer is a high incidence of malignant tumor. Some researches show there are overexpressions of epidermal growth factor receptor （EGFR）, vascular endothelial growth factor （VEGF） in the most of NSCLC, which cause tumor proliferation, vasculature and protoposis inhibited through the downstream signal transduction pathway. The EGFR-tyrosine kinases inhibitor （TKI） or anti-EGFR antibody or anti-VEGF antibody are the a gents to downregulate the activation of the signal transduction pathway by inhibiting TK or binding the EGFR or VEGF to control the development and progression of NSCLC with tolerable limited side effects. TKIs are effective for NSCLC. For Asian, non-smoke, adenocarcinoma, female, the response rates are much better than others, there is also good relation between efficacy and EGFR mutation. For anti-EGFR or VEGF antibody, they are different from TKI, they have showed promising results when added to chemo therapy based on clinical researches. Now the target＇s therapy has become another important systemic treatment for NSCLC as well as chemotherapy.