Reck Martin, Kranich Anne L, Steinbach Alma Katharina, Gatzemeier Ulrich
Onkologischer Schwerpunkt, Krankenhaus Grosshansdorf, Grosshansdorf.
Med Klin (Munich). 2005 Dec 15;100(12):785-93. doi: 10.1007/s00063-005-1130-1.
Lung cancer is one of the most common forms of cancer in western industrialized countries. Patients with advanced non-small cell lung cancer (NSCLC) have a poor prognosis and suffer many tumor-associated symptoms. Unfortunately, approximately 70% of patients with NSCLC present themselves with advanced poor-prognosis stage III and IV disease. In advanced disease, treatment is palliative and symptom-oriented. New less Adenotoxic drugs are urgently needed. One of the targets of new agents is the human epidermal growth factor receptor (EGFR/HER1), and agents targeting this receptor include erlotinib, gefitinib and cetuximab.
Erlotinib, gefitinib and cetuximab have been investigated in different clinical studies and provided objective responses and symptom relief. A benefit in survival could only be observed in second- and third-line therapy with erlotinib. All new agents have been generally well tolerated. Erlotinib was recently approved in the USA and Europe for second- and third-line treatment of patients with locally advanced or metastatic NSCLC.
Anti-EGFR has shown promising antitumor activity in NSCLC with a mild toxicity profile. However, some clinical issues such as screening for potentially responsive patients and optimal combination with other drugs should be the aim of future studies.
肺癌是西方工业化国家最常见的癌症形式之一。晚期非小细胞肺癌（NSCLC）患者预后较差，且会出现许多与肿瘤相关的症状。不幸的是，约70%的NSCLC患者就诊时已处于预后较差的晚期III期和IV期疾病。对于晚期疾病，治疗以姑息治疗和对症治疗为主。迫切需要新的低腺毒性药物。新型药物的靶点之一是人类表皮生长因子受体（EGFR/HER1），靶向该受体的药物包括厄洛替尼、吉非替尼和西妥昔单抗。
厄洛替尼、吉非替尼和西妥昔单抗已在不同的临床研究中进行了调查，并取得了客观缓解和症状缓解。仅在厄洛替尼的二线和三线治疗中观察到生存获益。所有新型药物总体耐受性良好。厄洛替尼最近在美国和欧洲被批准用于局部晚期或转移性NSCLC患者的二线和三线治疗。
抗EGFR在NSCLC中显示出有前景的抗肿瘤活性，且毒性较轻。然而，一些临床问题，如筛选潜在反应性患者以及与其他药物的最佳联合应用，应成为未来研究的目标。
