Sárosi Veronika, Balikó Zoltán
Baranya Megyei Kórház Tüdogyógyászat, C. osztály Pécs.
Orv Hetil. 2007 Aug 12;148(32):1525-9. doi: 10.1556/OH.2007.28095.
In advanced cases of non-small cell lung cancer, cytostatic treatment has small but assessable effect on patient survival as opposed to only symptomatic therapy. Cytostatic drugs, however, are known to have numerous side effects including neurotoxicity, nephrotoxicity, and myelosuppression. Better knowledge of tumor biology has led to the discovery of several key molecular pathways. Due to their beneficial effect and side effect profile, epidermal growth factor receptor tyrosine kinase inhibitors (gefitinib, erlotinib) have now been included in clinical practice in the treatment of non-small cell lung cancer. The predictive characteristics for the indication of these drugs have not yet been cleared up and require further clinical studies. Under the Expanded Access Program it has become possible to give patients with advanced non-small cell lung cancer (stages III/B and IV) epidermal growth factor receptor tyrosine kinase inhibitor erlotinib. Authors present here two cases to illustrate the beneficial effect of the drug when used as second or third line therapy. A more detailed study of the histological specimen (epidermal growth factor receptor expression as well as epidermal growth factor receptor gene mutation) will provide further information as to the anticipated efficacy for erlotinib.
在非小细胞肺癌的晚期病例中，与仅进行对症治疗相比，细胞抑制疗法对患者生存具有微小但可评估的效果。然而，已知细胞抑制药物有许多副作用，包括神经毒性、肾毒性和骨髓抑制。对肿瘤生物学更深入的了解已促成了若干关键分子途径的发现。鉴于表皮生长因子受体酪氨酸激酶抑制剂（吉非替尼、厄洛替尼）的有益效果和副作用情况，它们现已被纳入非小细胞肺癌治疗的临床实践中。这些药物适应证的预测特征尚未明确，需要进一步的临床研究。根据扩大使用项目，已能够为晚期非小细胞肺癌（Ⅲ/B期和Ⅳ期）患者提供表皮生长因子受体酪氨酸激酶抑制剂厄洛替尼。作者在此展示两例病例，以说明该药物作为二线或三线治疗时的有益效果。对组织学标本进行更详细的研究（表皮生长因子受体表达以及表皮生长因子受体基因突变）将为厄洛替尼的预期疗效提供更多信息。
