EGFR突变晚期非小细胞肺癌靶向治疗耐药后免疫治疗的新探索

New exploration of immunotherapy after drug resistance in advanced non-small cell lung cancer with EGFR mutation

表皮生长因子受体(EGFR)基因突变是亚洲晚期非小细胞肺癌(NSCLC)患者最常见的驱动基因突变类型。酪氨酸激酶抑制剂(EGFR-TKIs)是EGFR突变NSCLC一二线标准治疗药物,然而,耐药仍是无法避免的难题。对于耐药后无标准靶向药物治疗的患者,其后续治疗方案已经成为目前研究的热点与难点。尽管免疫检查点阻断剂(ICIs)已经成为驱动基因阴性的晚期NSCLC患者的标准治疗方案,但ICIs在EGFR突变的NSCLC中的一线疗效不佳,因此EGFR突变NSCLC耐药后能否可从免疫治疗中获益值得关注与探讨。文中主要对EGFR-TKIs耐药后免疫治疗现状及相关最新研究探索进行阐述,以期为临床及科学研究提供参考。

The epidermal growth factor receptor(EGFR)gene mutation is the most common type of driver mutation in Asian patients with advanced non-small cell lung cancer(NSCLC).Tyrosine kinase inhibitors(EGFR-TKIs)are the standard treatment for the first and second line of EGFR-mutated NSCLC.However,drug resistance is still an unavoidable problem.For the patients with no standard targeted drug therapy after drug resistance,the follow-up treatment has become a hot and difficult topic in current research.Although immune checkpoint blockers(ICIs)have become the standard treatment for patients with advanced NSCLC with driver negative genes,the first-line efficacy of ICIs in EGFR-mutated NSCLC is poor.Therefore,it is noteworthy to investigate whether EGFR-mutated NSCLC can benefit from immunotherapy after drug resistance.This paper describes the current status of immunotherapy after drug resistance of EGFR-TKIs and related latest research and exploration in order to provide reference for clinical and scientific research.