University of Michigan , Ann Arbor, MI, USA.
Henry Ford Cancer Institute , Detroit, MI, USA.
Expert Rev Anticancer Ther. 2020 Aug;20(8):647-661. doi: 10.1080/14737140.2020.1787156. Epub 2020 Jul 7.
Several targetable genetic alterations have been identified in non-small cell lung cancers (NSCLC) and drugs targeting these alterations have been approved for the management of advanced NSCLC patients. Driver mutations with emerging clinical trial data include exon 20 insertion mutations, amplification, point mutations, rearrangements, amplification and mutations, and amplification and translocations.
We reviewed English-language articles indexed in Medline and PubMed up to the 1 of June 2020. In addition, the proceedings of major conferences were reviewed for relevant abstracts. We report data published regarding targeted therapies which are currently approved and for those which are emerging in advanced or metastatic NSCLC.
While these drugs have been shown to be efficacious and tolerable, resistance almost always develops. Though next-generation tyrosine kinase inhibitors (TKIs) have been developed, the appropriate sequencing of these drugs is not clear. Evaluating combination therapies to prevent or delay the onset of resistance and understanding mechanisms of resistance are critical areas of emerging research.
非小细胞肺癌（NSCLC）中已确定了几种可靶向的遗传改变，并且已经批准了针对这些改变的药物来治疗晚期 NSCLC 患者。具有新兴临床试验数据的驱动基因突变包括外显子 20 插入突变、扩增、点突变、重排、扩增和突变，以及扩增和易位。
我们回顾了截至 2020 年 6 月 1 日在 Medline 和 PubMed 中索引的英文文章。此外，还对主要会议的会议记录进行了相关摘要的审查。我们报告了有关目前已批准的用于晚期或转移性 NSCLC 的靶向治疗的数据，以及那些正在出现的靶向治疗的数据。
虽然这些药物已被证明是有效且可耐受的，但几乎总是会产生耐药性。虽然已经开发出了下一代酪氨酸激酶抑制剂（TKI），但这些药物的适当使用顺序尚不清楚。评估联合治疗以预防或延迟耐药的发生以及了解耐药机制是新兴研究的关键领域。
