非小细胞肺癌靶向治疗的研究进展

Research progress of targeted therapy for non-small cell lung cancer

非小细胞肺癌的形成和发展与多种致癌突变相关,如表皮生长因子受体突变、肝细胞生长因子受体扩增等。目前,针对表皮生长因子受体和血管生成信号通路的靶向治疗在非小细胞肺癌的治疗中得到了广泛应用。多靶点酪氨酸激酶抑制剂可作用于肿瘤和细胞的多个靶点,并产生协同作用,能通过抑制肿瘤组织血管的生成来抑制肿瘤细胞生长。目前代表药物主要有安罗替尼、舒尼替尼、阿西替尼等。表皮生长因子受体可通过参与相关通路影响细胞增殖、分化,以及信号传导、血管形成。外显因子19、21是表皮生长因子受体常见的突变位点,常用的表皮生长因子受体突变抑制剂主要有吉非替尼、厄洛替尼、奥希替尼等。临床相关研究显示,在非小细胞肺癌的治疗中,靶向治疗药物作用更加精准,对正常组织的损伤小,不良反应率低,具有明显的优势。本文对近年来批准上市的非小细胞肺癌靶向治疗药物的临床应用进行了综述,以期能为非小细胞肺癌的临床治疗提供参考和借鉴。

The formation and development of non-small cell lung cancer are associated with a variety of carcinogenic mutations,such as epidermal growth factor receptor mutation,hepatocyte growth factor receptor amplification and so on.At present,the targeted therapy for epidermal growth receptor factor and angiogenesis signaling pathway has been widely used in the treatment of non-small cell lung cancer.Multi target tyrosine kinase inhibitors can act on multiple targets of tumor and cell,and produce synergistic effect.They can inhibit the growth of tumor cells by inhibiting the angiogenesis of tumor tissue.At present,the representative drugs mainly include anlotinib,sunitinib,acitinib,etc.Epidermal growth factor receptor(EGFR) can affect cell proliferation,differentiation,signal transduction and angiogenesis by participating in related pathways.Exon 19 and 21 are the common mutation sites of EGFR.The commonly used EGFR mutation inhibitors mainly include gefitinib,erlotinib,ositinib and so on.Relevant clinical studies show that in the treatment of non-small cell lung cancer,targeted therapy drugs have more accurate effect,less damage to normal tissue and low adverse drug reaction rate,which has significant advantage.This paper reviews the clinical application of targeted therapy drugs for non-small cell lung cancer approved in recent years,in order to provide reference for its clinical treatment.