Wang Z H, Song X Y
Department of Oncology, Shandong Cancer Hospital, Jinan 250117, China.
Zhonghua Zhong Liu Za Zhi. 2017 Feb 23;39(2):90-93. doi: 10.3760/cma.j.issn.0253-3766.2017.02.003.
EGFR tyrosine kinase inhibitors (TKIs) treatment has been established as standard therapy for EGFR-mutated adenocarcinomas. In the studies which published prospective randomized trials comparing EGFR TKIs with chemotherapy, a very low percentage of EGFR-mutated non-adenocarcinomas was enrolled in clinical trials. The efficacy of TKIs treatment for EGFR-mutated non-adenocarcinomas and their relationship with clinicopathological characteristics remain debatable. The results of retrospective studies show that the frequency of EGFR mutation is lower in non-adenocarcinoma than that of adenocarcinoma and efficacy of TKIs treatment for non-adenocarcinoma is inferior to adenocarcinoma. Smoking status is significantly associated with the efficacy of TKIs treatment for EGFR-mutated non-adenocarcinomas. The EGFR mutation rate and efficacy of TKIs treatment in adenosquamous cell carcinoma are higher than those of squamous cell carcinoma or large cell lung carcinoma. It may be concluded that the incidence of EGFR mutations in patients with non-adenocarcinoma NSCLC from mainland China is not very low and it is reasonable that EGFR TKIs could be an option for the treatment of EGFR-mutated non-adenocarcinoma NSCLC, especially for patients with adenosquamous histology and non-smokers. It is necessary to conduct a large-sample prospective study to understand the clinicopathological characteristics of non-adenocarcinomas and to evaluate the efficacy of EGFR TKI treatment or/and chemotherapy for EGFR-mutated non-adenocarcinoma NSCLC.
表皮生长因子受体酪氨酸激酶抑制剂(TKIs)治疗已被确立为表皮生长因子受体(EGFR)突变型腺癌的标准疗法。在已发表的比较EGFR TKIs与化疗的前瞻性随机试验研究中,临床试验纳入的EGFR突变型非腺癌患者比例非常低。TKIs治疗EGFR突变型非腺癌的疗效及其与临床病理特征的关系仍存在争议。回顾性研究结果显示,非腺癌中EGFR突变的发生率低于腺癌,TKIs治疗非腺癌的疗效也低于腺癌。吸烟状态与TKIs治疗EGFR突变型非腺癌的疗效显著相关。腺鳞癌中EGFR突变率及TKIs治疗的疗效高于鳞状细胞癌或大细胞肺癌。可以得出结论,中国大陆非腺癌非小细胞肺癌(NSCLC)患者中EGFR突变的发生率并不低,EGFR TKIs可作为EGFR突变型非腺癌NSCLC治疗的一种选择,尤其是对于腺鳞癌组织学类型和不吸烟的患者。有必要开展大样本前瞻性研究,以了解非腺癌的临床病理特征,并评估EGFR TKI治疗或/和化疗对EGFR突变型非腺癌NSCLC的疗效。