首页|晚期经治非小细胞肺癌EGFR-TKIs获得性RET融合突变耐药的研究进展

晚期经治非小细胞肺癌EGFR-TKIs获得性RET融合突变耐药的研究进展

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随着分子生物学研究的深入,非小细胞肺癌(NSCLC)开启了基于突变分子靶向治疗的精准医疗时代。表皮生长因子受体(EGFR)驱动突变与NSCLC的发生发展密切相关,基于此研发的EGFR-酪氨酸激酶抑制剂(TKIs)取得了显著的治疗效果,但获得性耐药仍是限制其长期应用的主要因素之一。EGFR-TKIs获得性耐药除包括EGFR再突变、MET扩增、HER2扩增、组织转化等外,受体酪氨酸激酶(RTK)融合突变被证实是一种罕见但可靶向的重要获得性耐药机制。在获得性RTK融合突变中,转染重排(RET)融合突变是研究者关注的可及靶点,随着对RET分子的不断探索,针对RET融合突变的药物相继获批上市,对于获得性RET融合突变介导EGFR-TKIs治疗的获得性耐药,目前临床上有不同的处理策略。本文就RET的结构和功能及其与EGFR-TKIs获得性耐药的关系及治疗策略进行综述,以期进一步改善患者生存结局。
Research progress on acquired RET fusion induces secondary resistance to EGFR therapy in advanced EGFR-mutated non-small cell lung cancer
With the in-depth study of molecular biology,non-small cell lung cancer(NSCLC)has opened the era of precision medicine based on mutation-based molecular targeting therapy.Epidermal growth factor receptor(EGFR)driver mutations are closely related to the progression of NSCLC,and EGFR-tyrosine kinase inhibitors(TKIs)developed based on this have achieved significant therapeutic effects,but acquired drug resistance is still one of the major factors limiting their long-term use.As resistance mechanisms are further investigated,in addition to secondary EGFR mutation,MET amplification,HER2 amplification,histologic transformation,etc.,receptor tyrosine kinase(RTK)fusion mutation have been shown to be a targetable mechanism of acquired resistance.Among the acquired RTK fusion mutations,rearranged during transfection(RET)fusion mutations are the accessible targets of our concern.As the RET molecule continues to be explored,drugs targeting RET fusions have been approved and marketed.There are different clinical strategies to deal with acquired RET fusion mutation mediating resistance to EGFR-TKIs treatment.In this review,the structure and function of RET,its relationship with EGFR-TKIs resistance,and treatment strategies are reviewed to further improve patient survival outcomes.

non-small cell lung cancertargeted therapyEGFR-TKIs resistancerearranged during transfection

王安、李涛、卢迪、卯云烨、秦嘉沛、周鑫、范昊、胡毅

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解放军总医院研究生院/解放军医学院,北京 100853

解放军总医院第一医学中心肿瘤内科,北京 100853

非小细胞肺癌 靶向治疗 EGFR-TKIs耐药 转染重排

国家卫生健康委员会专项重点课题

GWJJ2021100304

2024

解放军医学杂志
人民军医出版社

解放军医学杂志

CSTPCD北大核心
影响因子:1.644
ISSN:0577-7402
年,卷(期):2024.49(9)
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