Kosaka Takayuki, Yamaki Ei, Mogi Akira, Kuwano Hiroyuki
Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma, Japan.
J Biomed Biotechnol. 2011;2011:165214. doi: 10.1155/2011/165214. Epub 2011 Jun 2.
Gefitinib and erlotinib, which are epidermal growth factor receptor- (EGFR-) specific tyrosine kinase inhibitors (TKIs), are widely used as molecularly targeted drugs for non-small-cell lung cancer (NSCLC). Currently, the search for EGFR gene mutations is becoming essential for the treatment of NSCLC since these have been identified as predictive factors for drug sensitivity. On the other hand, in almost all patients responsive to EGFR-TKIs, acquired resistance is a major clinical problem. Mechanisms of acquired resistance reported in the past few years include secondary mutation of the EGFR gene, amplification of the MET gene, and overexpression of HGF; novel pharmaceutical agents are currently being developed to overcome resistance. This review focuses on these mechanisms of acquired resistance to EGFR-TKIs and discusses how they can be overcome.
吉非替尼和厄洛替尼是表皮生长因子受体(EGFR)特异性酪氨酸激酶抑制剂(TKIs),被广泛用作非小细胞肺癌(NSCLC)的分子靶向药物。目前,寻找EGFR基因突变对于NSCLC的治疗变得至关重要,因为这些突变已被确定为药物敏感性的预测因素。另一方面,在几乎所有对EGFR-TKIs有反应的患者中,获得性耐药是一个主要的临床问题。过去几年报道的获得性耐药机制包括EGFR基因的二次突变、MET基因的扩增和HGF的过表达;目前正在开发新型药物来克服耐药性。本综述重点关注这些对EGFR-TKIs的获得性耐药机制,并讨论如何克服它们。