Wang Xin, Zhong Diansheng
Department of Medical Oncology, Tianjin Medical University General Hospital, Tianjin 300052, China.
Zhongguo Fei Ai Za Zhi. 2018 Sep 20;21(9):686-691. doi: 10.3779/j.issn.1009-3419.2018.09.07.
Molecular target therapy is one of the most popular field of non-small cell lung cancer (NSCLC) treatmnet. Epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) rearragement are the most important two oncogenic drivers in NSCLC, early studies suggested that EGFR mutations and ALK rearrangements are mutually exclusive, but isolated cases or small sample research with concomitant EGFR and ALK alterations have been constantly reported. The co-occurrence of EGFR mutations and anaplastic lymphoma kinase (ALK) rearrangements constitutes a rare molecular, the frequency of EGFR/ALK co-alterations was about 1%, however, little has been known about clinicopathologic feature and treatment. This review summarized published case report, EGFR and ALK alterations are common in female, Asian origin, never smoker, IV stage, and denocarcinomas. First-line treatment can choose EGFR or ALK tyrosine kinase inhibitors (TKIs). However, studies about the origin and resistance mechanism in EGFR/ALK co-alterations are little, require more experimental and clinical research. .
分子靶向治疗是非小细胞肺癌(NSCLC)治疗中最热门的领域之一。表皮生长因子受体(EGFR)突变和间变性淋巴瘤激酶(ALK)重排是NSCLC中最重要的两个致癌驱动因素,早期研究表明EGFR突变和ALK重排相互排斥,但不断有关于EGFR和ALK同时改变的孤立病例或小样本研究被报道。EGFR突变和间变性淋巴瘤激酶(ALK)重排同时出现构成一种罕见分子,EGFR/ALK共同改变的频率约为1%,然而,关于其临床病理特征和治疗知之甚少。本综述总结了已发表的病例报告,EGFR和ALK改变在女性、亚洲裔、从不吸烟者、IV期和腺癌中常见。一线治疗可选择EGFR或ALK酪氨酸激酶抑制剂(TKIs)。然而,关于EGFR/ALK共同改变的起源和耐药机制的研究很少,需要更多的实验和临床研究。