Bartholomew C, Eastlake L, Dunn P, Yiannakis D
Oncology Department, Plymouth Hospitals NHS Trust, United Kingdom.
Respir Med Case Rep. 2017 Feb 4;20:137-140. doi: 10.1016/j.rmcr.2017.01.016. eCollection 2017.
Specific oncogenes with driver mutations, such as the Epidermal Growth Factor Receptor (EGFR 1) gene can lead to non-small-cell lung cancer formation. Identification of these oncogenes, their driver mutations and downstream effects allow the targeting of these pathways by drugs. Such personalised therapy has become an important strategy in combating lung cancer and highlights the need to test for these mutations. Tyrosine Kinase Inhibitors (TKIs) against EGFR, such as Erlotinib, are able to halt these tumour promoting properties in non-small-cell lung cancers. Third generation EGFR TKIs, such as Osimertinib, are focussing on resulting acquired TKI resistance. Here we report the clinical course of a patient with metastatic non-small-cell lung cancer who has undergone EGFR targeted therapy and been further challenged by TKI acquired resistance. Her extended survival and maintained quality of life are a consequence of these modern, genotype-targeted, personalised metastatic non-small-cell lung cancer therapies.
具有驱动突变的特定致癌基因，如表皮生长因子受体（EGFR 1）基因，可导致非小细胞肺癌的形成。识别这些致癌基因、它们的驱动突变和下游效应，有助于通过药物靶向这些通路。这种个性化治疗已成为对抗肺癌的一项重要策略，并凸显了检测这些突变的必要性。针对EGFR的酪氨酸激酶抑制剂（TKIs），如厄洛替尼，能够在非小细胞肺癌中阻止这些促进肿瘤的特性。第三代EGFR TKIs，如奥希替尼，专注于解决由此产生的获得性TKI耐药性问题。在此，我们报告了一名转移性非小细胞肺癌患者的临床病程，该患者接受了EGFR靶向治疗，并受到TKI获得性耐药的进一步挑战。她的生存期延长和生活质量得以维持，得益于这些现代的、针对基因型的、个性化的转移性非小细胞肺癌治疗方法。
