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表皮生长因子受体(EGFR)突变的非小细胞肺癌(NSCLC)

Epidermal Growth Factor Receptor (EGFR)-Mutated Non-Small-Cell Lung Cancer (NSCLC).

作者信息

O'Leary Connor, Gasper Harry, Sahin Katherine B, Tang Ming, Kulasinghe Arutha, Adams Mark N, Richard Derek J, O'Byrne Ken J

机构信息

Princess Alexandra Hospital, Brisbane 4000, Australia.

School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane 4000, Australia.

出版信息

Pharmaceuticals (Basel). 2020 Sep 25;13(10):273. doi: 10.3390/ph13100273.

Abstract

Epidermal growth factor receptor (EGFR) mutations are the most common oncogenic drivers in non-small-cell lung cancer (NSCLC). Significant developments have taken place which highlight the differences in tumor biology that exist between the mutant and wild-type subtypes of NSCLC. Patients with advanced EGFR-mutant NSCLC have a variety of EGFR-targeting agents available proven to treat their disease. This has led to superior patient outcomes when used as a monotherapy over traditional cytotoxic systemic therapy. Attempts at combining EGFR agents with other anticancer systemic treatment options, such as chemotherapy, antiangiogenic agents, and immunotherapy, have shown varied outcomes. Currently, no specific combination stands out to cause a shift away from the use of single-agent EGFR inhibitors in the first-line setting. Similarly, adjuvant EGFR inhibitors, are yet to significantly add to patient overall survival if used at earlier timepoints in the disease course. Liquid biopsy is an evolving technology with potential promise of being incorporated into the management paradigm of this disease. Data are emerging to suggest that this technique may be capable of identifying early resistance mechanisms and consequential disease progression on the basis of the analysis of blood-based circulating tumor cells.

摘要

表皮生长因子受体(EGFR)突变是非小细胞肺癌(NSCLC)中最常见的致癌驱动因素。已经取得了重大进展,这些进展突出了NSCLC突变型和野生型亚型之间存在的肿瘤生物学差异。晚期EGFR突变型NSCLC患者有多种经证实可治疗其疾病的EGFR靶向药物。与传统的细胞毒性全身治疗相比,单药使用这些药物时患者预后更佳。将EGFR药物与其他抗癌全身治疗方案(如化疗、抗血管生成药物和免疫治疗)联合使用的尝试显示出不同的结果。目前,在一线治疗中,没有哪种特定的联合方案能显著改变单药EGFR抑制剂的使用。同样,如果在疾病进程的早期使用辅助性EGFR抑制剂,也尚未能显著提高患者的总生存期。液体活检是一项不断发展的技术,有望被纳入该疾病的管理模式。越来越多的数据表明,该技术可能能够通过分析血液中的循环肿瘤细胞来识别早期耐药机制和随之而来的疾病进展。

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