在EGFR突变阳性非小细胞肺癌中获得耐药性的治疗选择和考虑
X Le1, S Popat2, J V Heymach1
1Department of Thoracic Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
ESMO open
|January 28, 2026
概括
针对EGFR突变阳性非小细胞肺癌 (NSCLC) 的新疗法正在出现,该癌症已经对氨酸激酶抑制剂 (TKIs) 产生耐药性. 重复活检和个性化治疗是克服耐药性和改善患者治疗结果的关键.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 遗传学 是一个遗传学.
背景情况:
- 皮表皮生长因子受体 (EGFR) 氨酸激酶抑制剂 (TKI) 是EGFR突变阳性 (EGFRm阳性) 先进的非小细胞肺癌 (NSCLC) 的标准一线治疗方法.
- 对EGFR TKIs的获得性耐药性是一个重大挑战,最佳的后续治疗策略尚未得到充分确立.
研究的目的:
- 审查关于治疗方法的最新临床试验数据,以克服EGFRm阳性晚期NSCLC中对EGFRTKI的获得性耐药性.
- 总结潜在的策略,包括重复活检,识别耐药性突变和新型组合疗法.
主要方法:
- 审查最近的临床试验数据和关于在NSCLC中对EGFR TKIs获得的耐药性的文献.
- 对各种策略的治疗结果的分析,包括化疗,向疗法和新组合.
- 考虑诸如组织学转变和大脑转移等因素.
主要成果:
- 重复活检对于检测组织学转变至关重要,对于此,以为基础的化疗是标准.
- 虽然识别可操作的抗性突变可以为个性化治疗提供信息,但它尚未成为明确的护理标准.
- 与免疫疗法,双特异性抗体和抗体-药物合物的组合显示出改善无进展生存率和整体生存率的前景,包括在脑转移患者中.
结论:
- 在NSCLC中对EGFR TKIs获得的耐药性的有效管理需要采用多方面的方法.
- 重复活检和考虑新的组合疗法对于改善结果至关重要.
- 医生和患者之间的共同决策越来越重要,因为治疗选择的扩大及其相关的副作用.
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