非小细胞肺癌EGFR基因突变与靶向治疗研究进展

Research progress of EGFR gene mutation and targeted therapy in non-small cell lung cancer

肺癌男性发病率为第一位,女性发病率第二位,死亡率第一位。肺癌病理类型中80%为非小细胞肺癌(NSCLC),此类患者确诊时大多为晚期或局部晚期,丧失手术机会而采用放化疗等非根治性治疗。但以铂类为基础联合第三代化疗药物虽然能够延长患者生存期,但多数患者接受3个周期以上化疗后产生耐药。近年来随着分子生物学技术及靶向药物研发的进展,肺癌靶向治疗取得了长足的进步。以小分子酪氨酸激酶抑制剂为主靶向治疗能明显延长表皮生长因子受体(EGFR)存在19和21外显子突变的患者。EGFR基因19、21外显子突变,被认为是肺癌靶向治疗效果预测的重要分子标记。近年来随着肺癌靶向治疗的不断研究,EGFR基因突变状态与靶向药物疗效的关系得到了广泛的关注。本文对几年来关于NSCLC EGFR基因突变及靶向药物治疗研究的相关文献进行综述,以期为临床NSCLC的治疗提供参考。

Lung cancer incidence is the first for male, 2 th for female and the first in mortality.About 80%of the pathological types of lung cancer are non-small cell lung cancer(NSCLC).Most of these patients are diagnosed in advanced or locally advanced stages.They lose the chance of operation and adopt non-radical treatment such as radiotherapy and chemotherapy.However,platinum-based combination with thirdgeneration chemotherapeutic drugs can prolong the survival time of patients,but most patients after more than three cycles of chemotherapy have drug resistance.In recent years,with the development of molecular biology technology and targeted drug research and development,targeted therapy for lung cancer has made considerable progress.Targeted therapy with small molecule tyrosine kinase inhibitors can significantly prolong the presence of exon 19 and 21 mutations in epidermal growth factor receptor(EGFR).The mutation of exon 19,21 of EGFR gene is considered as an important molecular marker for predicting the therapeutic effect of targeted lung cancer.In recent years,with the continuous research of targeted therapy for lung cancer, the relationship between EGFR gene mutation status and the efficacy of targeted drugs has received extensive attention.This article reviews the recent literature on EGFR gene mutation and targeted drug therapy in NSCLC, with a view to providing reference for clinical treatment of NSCLC.