表皮生长因子受体酪氨酸激酶抑制剂耐药后非小细胞肺癌免疫治疗的研究进展
Research Progress on Immunotherapy for Non-Small Cell Lung Cancer Resistant to Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitor
史志琦 1赵丽丽 2朱艺宸 3谢宇欣 1田金 2龙麟 2肖军2
作者信息
- 1. 山东中医药大学第一临床医学院,山东济南 250014
- 2. 青岛大学附属青岛市海慈医院(青岛市中医医院),山东青岛 266033
- 3. 青岛大学青岛医学院,山东青岛 266071
- 折叠
摘要
表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor-tyrosine kinase inhibitor,EGFR-TKI)是表皮生长因子受体(epidermal growth factor receptor,EGFR)突变的晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的标准一线治疗方案,EGFR-TKI耐药严重影响患者预后,EGFR-TKI耐药机制的探讨及后续治疗是当前研究的难点和重点.近年来,免疫检查点抑制剂在EGFR-TKI耐药晚期NSCLC的治疗中展现出显著优势.全文就EGFR-TKI耐药NSCLC的免疫相关机制、免疫单药、免疫联合靶向、化疗、抗血管生成、双抗等治疗现状进行分析,并就PD-L1表达、肿瘤突变负荷(tumor mutation burden,TMB)、EGFR突变类型及代谢产物等指标预测选择EGFR-TKI耐药后的优势人群进行阐述,以期为EGFR-TKI耐药NSCLC患者治疗研究及临床提供参考.
Abstract
Epidermal growth factor receptor-tyrosine kinase inhibitor(EGFR-TKI)is the standard first-line treatment option for patients with advanced non-small cell lung cancer(NSCLC)with epidermal growth factor receptor(EGFR)mutations.EGFR-TKI resistance seriously affects the prognosis of patients,and the explo-ration of the mechanism of EGFR-TKI resistance and the subsequent treatment are the difficulties and focuses of the current research.In recent years,immune checkpoint inhibitors have demonstrated significant advan-tages in the treatment of EGFR-TKI-resistant advanced NSCLC.This paper analyzes the immune related mech-anisms,immune monotherapy,immune combination targeting,chemotherapy,anti angiogenesis,dual anti-body and other treatment status of EGFR-TKI resistant NSCLC.It also elaborates on the prediction of PD-L1 expression,tumor mutation burden(TMB),EGFR mutation type and metabolic products to select the domi-nant population after EGFR-TKI resistance,in order to provide reference for the treatment research and clini-cal practice of EGFR-TKI resistant NSCLC patients.
关键词
非小细胞肺癌/表皮生长因子受体酪氨酸激酶抑制剂/表皮生长因子受体/免疫疗法/耐药Key words
non-small cell lung cancer/epidermal growth factor receptor-tyrosine kinase inhibitor/epi-dermal growth factor receptor/immunotherapy/resistance引用本文复制引用
出版年
2024
NETL
NSTL
万方数据