晚期非小细胞肺癌EGFR-TKI失败后的治疗策略

Treatment after the failure of EGFR-TKI in patients with advanced non-small cell lung cancer

表皮生长因子受体-酪氨酸激酶抑制剂(EGFR-TKI)治疗范围涵盖了晚期非小细胞肺癌(NSCLC)的二线、三线治疗和一线治疗甚至维持治疗,许多患者在其治疗过程中的某个阶段出现对TKI耐药或TKI失败,但目前尚无高级别、可信的临床研究证据指导EGFR-TKI失败后的治疗。一般可从两个层面考虑:(1)基于一些初步的结果和经验,根据TKI治疗阶段选择后续治疗。(2)根据TKI治疗失败或耐药分子机制,有针对性地选择后续治疗。

Epidermal growth factor receptor-tyrosine kinase inhibitor（EGFR-TKI） treatment covers the second and third line treatment,first-line treatment and even maintenance treatment of advanced non-small cell lung cancer（NSCLC）.So more and more patients will be confronted with TKI resistance or failure.There is no high-level,credible evidence to guide the follow-up therapy after the failure of EGFR-TKI for advanced NSCLC.Treatment options will be considered on two dimensions： sequential treatment is considered according to the therapy line of EGFR-TKI based on some preliminary results and experience;the choice of sequential treatment is targeted according to the molecular mechanisms of TKI treatment failure or drug resistance.