Dou Yan, Jiang Da
Department of Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China.
Zhongguo Fei Ai Za Zhi. 2021 Jan 20;24(1):56-62. doi: 10.3779/j.issn.1009-3419.2021.102.02.
Lung cancer is one of the cancers with the highest incidence in the world, and there is no standard treatment plan after second-line progression. Tumor angiogenesis has now been identified as an important therapeutic target for malignant tumors. Small molecule multi-target vascular kinase inhibitors can inhibit tumor angiogenesis by inhibiting angiogenesis-related signal pathways. At present, a lot of clinical trials of small molecule anti-angiogenic drugs for the treatment of non-small cell lung cancer (NSCLC) have been carried out, and some vascular endothelial growth factor receptor-tyrosine kinase inhibitors (VEGFR-TKIs) have been approved for the treatment of advanced NSCLC. Based on the development status of multiple small molecule anti-angiogenic drugs at home and abroad for the treatment of NSCLC, this article summarizes the efficacy and safety studies of multiple VEGFR-TKIs and fibroblast growth factor receptor (FGFR)-TKI single agents or combination treatments [including combined with chemotherapy, epidermal growth factor receptor (EGFR)-TKIs, immunotherapy, and radiotherapy, etc.] for NSCLC, and at the same time discussed the possible existence of VEGFR-TKIs drug resistance mechanisms and efficacy predictors, etc., and prospect the future development trend and potential problems of anti-vascular treatment of NSCLC, and provide new ideas for the follow-up precision and individualized treatment of lung cancer. .
肺癌是全球发病率最高的癌症之一,二线进展后尚无标准治疗方案。肿瘤血管生成现已被确定为恶性肿瘤的重要治疗靶点。小分子多靶点血管激酶抑制剂可通过抑制血管生成相关信号通路来抑制肿瘤血管生成。目前,已开展了许多小分子抗血管生成药物治疗非小细胞肺癌(NSCLC)的临床试验,一些血管内皮生长因子受体酪氨酸激酶抑制剂(VEGFR-TKIs)已被批准用于治疗晚期NSCLC。基于国内外多种小分子抗血管生成药物治疗NSCLC的发展现状,本文总结了多种VEGFR-TKIs和成纤维细胞生长因子受体(FGFR)-TKI单药或联合治疗(包括联合化疗、表皮生长因子受体(EGFR)-TKIs、免疫治疗和放疗等)治疗NSCLC的疗效和安全性研究,同时探讨了VEGFR-TKIs可能存在的耐药机制和疗效预测指标等,并对NSCLC抗血管治疗的未来发展趋势和潜在问题进行了展望,为肺癌后续的精准和个体化治疗提供新思路。