Bai Rilan, Chen Naifei, Cui Jiuwei
Cancer Center, the First Hospital of Jilin University, Changchun 130021, China.
Zhongguo Fei Ai Za Zhi. 2018 Aug 20;21(8):641-648. doi: 10.3779/j.issn.1009-3419.2018.08.11.
In recent years, epidermal growth factor receptor tyrosine kinase inhibitors have been recommended by many guidelines as first-line drugs for advanced non-small cell lung cancer (NSCLC) with EGFR gene mutations and no resistance. However, with the prolongation of medication time, most appear acquired resistance. In recent years, breakthroughs in inhibitors of programmed death-1 (PD-1) and its ligand (PD1 ligand, PD-L1) have rapidly changed the therapeutic model of NSCLC. Recent studies have shown that the efficacy of immune checkpoint inhibitors in EGFR-mutant NSCLC patients is not satisfactory, which might be caused by low PD-L1 expression, inhibitory immune microenvironment and low tumor mutation load. This review will elaborate the immune microenvironment of NSCLC patients with EGFR mutation, the latest study progression of immune checkpoint inhibitors and its combined with TKI, expecting to bring new hopes for the treatment of EGFR-mutant NSCLC patients. .
近年来，表皮生长因子受体酪氨酸激酶抑制剂已被许多指南推荐为具有EGFR基因突变且无耐药性的晚期非小细胞肺癌（NSCLC）的一线用药。然而，随着用药时间的延长，大多数患者会出现获得性耐药。近年来，程序性死亡-1（PD-1）及其配体（PD-1配体，PD-L1）抑制剂的突破迅速改变了NSCLC的治疗模式。最近的研究表明，免疫检查点抑制剂在EGFR突变的NSCLC患者中的疗效并不理想，这可能是由于PD-L1表达低、免疫抑制微环境和肿瘤突变负荷低所致。本文将阐述EGFR突变NSCLC患者的免疫微环境、免疫检查点抑制剂及其与酪氨酸激酶抑制剂联合应用的最新研究进展，期望为EGFR突变NSCLC患者的治疗带来新希望。
