Jiangsu Key Laboratory of Bioactive Natural Product Research and State Key Laboratory of Natural Medicines, School of Traditional Chinese Pharmacy, China Pharmaceutical University, 24 Tong Jia Xiang, 210009 Nanjing, China.
Department of Pathology, Jiangsu Cancer Hospital, 210009 Nanjing, China.
Pharmacol Res. 2021 May;167:105583. doi: 10.1016/j.phrs.2021.105583. Epub 2021 Mar 26.
With the development of precision medicine, molecular targeted therapy has been widely used in the field of cancer, especially in non-small-cell lung cancer (NSCLC). Epidermal growth factor receptor (EGFR) is a well-recognized and effective target for NSCLC therapies, targeted EGFR therapy with EGFR-tyrosine kinase inhibitors (EGFR-TKIs) has achieved ideal clinical efficacy in recent years. Unfortunately, resistance to EGFR-TKIs inevitably occurs due to various mechanisms after a period of therapy. EGFR mutations, such as T790M and C797S, are the most common mechanism of EGFR-TKI resistance. Here, we discuss the mechanisms of EGFR-TKIs resistance induced by secondary EGFR mutations, highlight the development of targeted drugs to overcome EGFR mutation-mediated resistance, and predict the promising directions for development of novel candidates.
随着精准医学的发展,分子靶向治疗已广泛应用于癌症领域,尤其是非小细胞肺癌(NSCLC)。表皮生长因子受体(EGFR)是 NSCLC 治疗的一个公认且有效的靶点,近年来,针对 EGFR 的靶向 EGFR 酪氨酸激酶抑制剂(EGFR-TKIs)已取得了理想的临床疗效。不幸的是,由于各种机制,在一段时间的治疗后,EGFR-TKIs 不可避免地会产生耐药性。EGFR 突变,如 T790M 和 C797S,是 EGFR-TKI 耐药最常见的机制。在这里,我们讨论了由二次 EGFR 突变引起的 EGFR-TKIs 耐药的机制,重点介绍了克服 EGFR 突变介导的耐药性的靶向药物的发展,并预测了新型候选药物的有前景的发展方向。