肺癌的靶向治疗 - 第三军医大学学报.doc

肺癌的靶向治疗 王孟昭，张紫萱 （100730 北京，中国医学科学院中国协和医科大学北京协和医院呼吸内科） [关键词] 肺癌；靶向治疗 [中图法分类号] [文献标志码] A Target therapy in lung cancer Wang Mengzhao, Zhang Zixuan (Department of Respiratory Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China) [Abstract] Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), as a standard target therapy in lung cancer, has been developed as a chemotherapy drug. Many clinical trials with TKIs as third line, second line and first line treatment for lung cancer patients were carried out. Only EGFR gene mutations could predict benefit from TKIs treatment for patients with lung cancer. Based on the experiences from the development of TKIs, Crizotinib (Xalkori, Pfizer) is quickly approved for treatment of some patients with non-small cell lung carcinoma (NSCLC) harboring ALK gene rearrangement in every line. We believe that many other target drugs would be used in clinical practice to treat lung cancer patients. Identification of driver mutations in tumor specimens from Chinese patients is very important. Basic research and drug development in China will be promoted from the discovery of new driver mutations, especially in squamous cell lung cancer and small cell lung cancer. Based on the results of driver mutations tests, Chinese patients will be benefited from global research findings. Corresponding author: Wang Mengzhao, Tel: 86-10E-mail：mengzhaowang@ [通信作者] 王孟昭，男，博士教授20世纪90年代以来，随着人们对肺癌驱动基因的认识，相应的靶向治疗研究也不断深入，以肿瘤分子特点为基础的个体化治疗越来越受重视。表皮生长因子受体酪氨酸激酶抑制剂（epidermal growth factor receptor tyrosine kinase inhibitors ，EGFR-TKIs）是最早进入临床应用的靶向治疗药物，研究表明其针对的是EGFR基因突变患者。间变性淋巴瘤激酶（anaplastic lymphoma kinase,ALK）基因融合变异与相应靶向抑制剂克唑替尼（Crizotinib）的关系近期已得到临床研究的证实。EGFR-TKIs依旧是最重要的肺癌靶向治疗药物。 1 EGFR-TKIs 人们对EGFR-TKI最早的研究是ISEL和BR.21，这2个研究分别证实了吉非替尼和厄罗替尼与安慰剂相比能延长亚裔晚期非小细胞肺癌（non-small cell lung carcinoma，NSCLC) NSCLC患者一线治疗失败后的生存期。此后多项研究比较了EGFR-TKIs和标准化