Sun Ya-Wen, Xu Jian, Zhou Jun, Liu Wen-Juan
Shandong Cancer Hospital and Institute, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, China.
Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.
Oncotarget. 2017 Dec 22;9(4):5459-5472. doi: 10.18632/oncotarget.23616. eCollection 2018 Jan 12.
Brain metastases are very common in lung cancer patients. The condition of these patients is complicated and difficult to treat, and adverse reactions following treatment can affect the nervous system, which severely reduces quality of life. Lung cancers are categorized as small cell lung cancers and non-small cell lung cancers. Patients with brain metastasis of small cell lung cancers are generally treated with brain radiotherapy and systemic chemotherapy, but stage III/IV patients with brain metastasis of non-small cell lung cancers are generally not responsive to radiotherapy or chemotherapy. With the recent development of targeted drugs, tumor molecular profile detection allows the selection of appropriate targeted drugs for adjuvant pharmacological treatment of brain metastasis in lung cancer patients. In recent years, immune checkpoint inhibitors have emerged and have been approved by the Food and Drug Administration (FDA) for the treatment of certain cancers, but their efficacy in lung cancer patients with brain metastases still needs to be confirmed. This paper focuses on highlighting drugs for targeted therapy of brain metastasis in lung cancer patients and their molecular targets and mechanisms of drug resistance.
脑转移在肺癌患者中非常常见。这些患者的病情复杂且难以治疗,治疗后的不良反应会影响神经系统,严重降低生活质量。肺癌分为小细胞肺癌和非小细胞肺癌。小细胞肺癌脑转移患者一般采用脑部放疗和全身化疗,但非小细胞肺癌脑转移的Ⅲ/Ⅳ期患者通常对放疗或化疗无反应。随着靶向药物的近期发展,肿瘤分子谱检测能够为肺癌脑转移患者的辅助药物治疗选择合适的靶向药物。近年来,免疫检查点抑制剂出现并已获美国食品药品监督管理局(FDA)批准用于治疗某些癌症,但其对肺癌脑转移患者的疗效仍有待证实。本文重点介绍肺癌脑转移患者的靶向治疗药物及其分子靶点和耐药机制。