免疫检查点抑制剂在EGFR突变非小细胞肺癌中的应用

Application of immune checkpoint inhibitors in non-small cell lung cancer with EGFR mutant

表皮生长因子受体(EGFR)基因是非小细胞肺癌患者最常见的驱动基因之一,免疫检查点抑制剂(ICI)在EGFR突变非小细胞肺癌的临床应用中至今颇具争议。程序性死亡配体1(PD-L1)的表达丰度是指导ICI应用的重要预测指标,EGFR突变可能影响肿瘤细胞中PD-L1的表达。近期临床研究指出,ICI单药对EGFR突变的患者缺乏疗效,但ICI联合化疗以及IMpower150试验中提出的四药联合方式在EGRF突变患者中展现出了良好的临床效益,另外ICI与表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)组合模式的安全性还需进一步明确。

Epidermal growth factor receptor(EGFR)gene is one of the most common driving genes in non-small cell lung cancer patients,and immune checkpoint inhibitors(ICIs)have been controversial in the clinical application of non-small cell lung cancer with EGFR mutant.The expression abundance of programmed death ligand 1(PD-L1)is an important predictor to guide the application of ICIs,and EGFR mutations may affect PD-L1 expression in tumor cells.Recent clinical studies have pointed out that the single drug of ICIs is not effective in patients with EGFR mutation,however,the combination of ICIs combined with chemotherapy and the four drugs proposed in the IMpower150 trial show good clinical benefits.In addition,the safety of ICIs and epidermal growth factor receptor-tyrosine kinase inhibitor(EGFR-TKI)combination model needs to be further clarified.