靶向治疗时代下的非小细胞肺癌化疗现状与进展

The current situation and progression of chemotherapy for non-small cell lung cancer under the era of targeted therapy

目前,对非小细胞肺癌(non-small cell lung cancer,NSCLC)的治疗已经进入靶向治疗时代。对表皮生长因子受体(epidermal growth factor receptor,EGFR)基因状态明确的NSCLC患者,其治疗推荐已有共识:对EGFR基因突变患者应优先选用EGFR酪氨酸激酶抑制剂(tyrosine kinase inhibitors,TKI)治疗。但对EGFR基因野生型及经EGFR TKI一线治疗失败的患者,化疗仍是首选的治疗方式。本文从循证医学角度,通过回顾相关临床研究数据,分析靶向治疗时代下的NSCLC化疗的合理选择与联合治疗。

At present, the treatment of non-small cell lung cancer （NSCLC） has come into the era of targeted therapy. The treatment recommendations for the advanced NSCLC with clear epidermal growth factor receptor （EGFR） gene status have reached a consensus： patients with EGFR mutation-positive NSCLC can give priority to EGFR tyrosine kinase inhibitors, which can maximize the benefit from the treatment; while the patients with wild-type EGFR gene and failure after the first-line treatment should still regard chemotherapy as first choice. We thoroughly review the related clinical trial from the point of view of evidence-based medicine, and analyze the reasonable selection and combination of chemotherapy under the era of targeted therapy.