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奥希替尼靶向治疗非小细胞肺癌的研究进展

Targeting Aberrations in Non-Small Cell Lung Cancer with Osimertinib.

机构信息

Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.

Department of Pathology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China.

出版信息

Clin Cancer Res. 2018 Jun 1;24(11):2594-2604. doi: 10.1158/1078-0432.CCR-17-1875. Epub 2018 Jan 3.

Abstract

(or ) aberrations, including both amplification and mutations, have been classified as oncogenic drivers that contribute to 2% to 6% of lung adenocarcinomas. amplification is also an important mechanism for acquired resistance to EGFR tyrosine kinase inhibitors (TKI). However, due to limited preclinical studies and clinical trials, currently there is still no available standard of care for lung cancer patients with aberrations. To fulfill the clinical need for targeting in patients with non-small cell lung cancer (NSCLC), we performed a comprehensive preclinical study to evaluate the efficacy of a third-generation TKI, osimertinib (AZD9291). Three genetically modified mouse models (GEMM) mimicking individual alterations in NSCLC were generated, and osimertinib was tested for its efficacy against these aberrations Osimertinib treatment showed robust efficacy in HER2 overexpression and models, but not in exon 20 insertion tumors. Interestingly, we further identified that combined treatment with osimertinib and the BET inhibitor JQ1 significantly increased the response rate in -mutant NSCLC, whereas JQ1 single treatment did not show efficacy. Overall, our data indicated robust antitumor efficacy of osimertinib against multiple aberrations in lung cancer, either as a single agent or in combination with JQ1. Our study provides a strong rationale for future clinical trials using osimertinib either alone or in combination with epigenetic drugs to target aberrant in patients with NSCLC. .

摘要

(或)畸变,包括扩增和突变,已被归类为致癌驱动因素,导致 2%至 6%的肺腺癌发生。扩增也是获得性对表皮生长因子受体酪氨酸激酶抑制剂(TKI)耐药的重要机制。然而,由于临床前研究和临床试验的局限性,目前针对具有 畸变的肺癌患者,仍然没有标准的治疗方法。为了满足非小细胞肺癌(NSCLC)患者针对 治疗的临床需求,我们进行了一项全面的临床前研究,评估第三代 TKI,奥希替尼(AZD9291)的疗效。我们构建了三个模拟 NSCLC 中单个 改变的基因修饰小鼠模型(GEMM),并测试了奥希替尼针对这些 畸变的疗效。奥希替尼治疗在 HER2 过表达和 模型中显示出强大的疗效,但在 外显子 20 插入肿瘤中无效。有趣的是,我们进一步发现,奥希替尼和 BET 抑制剂 JQ1 的联合治疗显著提高了 -突变 NSCLC 的反应率,而 JQ1 单药治疗则没有疗效。总体而言,我们的数据表明奥希替尼对肺癌中多种 畸变具有强大的抗肿瘤疗效,无论是作为单一药物还是与 JQ1 联合使用。我们的研究为未来的临床试验提供了强有力的理由,即在 NSCLC 患者中使用奥希替尼单药或联合表观遗传药物来靶向 畸变。

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