EGFR-TKI在EGFR突变非小细胞肺癌治疗中的应用现状及进展

Application status and progress of EGFR-TKI in the treatment of EGFR-mutant non-small cell lung cancer

表皮生长因子受体(EGFR)突变是非小细胞肺癌(NSCLC)中最常见的致癌驱动因素。表皮生长因子受体-酪氨酸激酶抑制剂(EGFR-TKI)广泛应用于肺癌治疗中,特别是晚期NSCLC的一线治疗,与标准化疗相比,EGFR-TKI单药治疗已获得较好的疗效及耐受性。而EGFR-TKI在新辅助治疗、辅助治疗及晚期一线与其他药物联合治疗中的疗效尚未明确,获得性耐药成为了限制其疗效的主要问题。分子靶向治疗是驱动基因指导下的治疗,开启了非鳞非小细胞肺癌“个体化”与“精准”治疗时代。本文就EGFR-TKI治疗NSCLC的临床价值及耐药机制进行综述。

Epidermal growth factor receptor(EGFR)mutations are the most common oncogenic driver in non-small cell lung cancer(NSCLC).Epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKIs)have been widely used in lung cancer treatment,especially in the first-line treatment of advanced NSCLC,and EGFR-TKI monotherapy has achieved better efficacy and tolerability compared with standard chemotherapy.While the efficacy of EGFR-TKI in neoadjuvant therapy,adjuvant therapy and advanced first-line combination with other agents has not been clearly established,acquired drug resistance has become a major issue limiting its efficacy.Molecular targeted therapy is a driver gene-guided therapy,which has opened the era of"individualized"and"precise"treatment for non-squamous non-small cell lung cancer.This article reviews the clinical value and drug resistance mechanism of EGFR-TKI in the treatment of NSCLC.