Peng Weiwei, Yao Chengyun, Pan Qin, Zhang Zhi, Ye Jinjun, Shen Bo, Zhou Guoren, Fang Ying
Department of Medical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China.
Department of Radiation Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China.
Front Oncol. 2023 Feb 23;13:1120278. doi: 10.3389/fonc.2023.1120278. eCollection 2023.
Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) represented by gefitinib and erlotinib are widely used in treating non-small cell lung cancer (NSCLC). However, acquired resistance to EGFR-TKI treatment remains a clinical challenge. In recent years, emerging research investigated in EGFR-TKI-based combination therapy regimens, and remarkable achievements have been reported. This article focuses on EGFR-TKI-based regimens, reviews the standard and novel application of EGFR targets, and summarizes the mechanisms of EGFR-TKI combinations including chemotherapy, anti-vascular endothelial growth factor monoclonal antibodies, and immunotherapy in the treatment of NSCLC. Additionally, we summarize clinical trials of EGFR-TKI-based combination therapy expanding indications to mutation-negative lung malignancies. Moreover, novel strategies are under research to explore new drugs with good biocompatibility. Nanoparticles encapsulating non-coding RNA and chemotherapy of new dosage forms drawn great attention and showed promising prospects in effective delivery and stable release. Overall, as the development of resistance to EGFR-TKIs treatment is inevitable in most of the cases, further research is needed to clarify the underlying mechanism of the resistance, and to evaluate and establish EGFR-TKI combination therapies to diversify the treatment landscape for NSCLC.
以吉非替尼和厄洛替尼为代表的表皮生长因子受体(EGFR)-酪氨酸激酶抑制剂(TKIs)被广泛用于治疗非小细胞肺癌(NSCLC)。然而,对EGFR-TKI治疗产生获得性耐药仍然是一项临床挑战。近年来,针对基于EGFR-TKI的联合治疗方案展开了新的研究,并取得了显著成果。本文聚焦于基于EGFR-TKI的治疗方案,回顾EGFR靶点的标准及新应用,并总结EGFR-TKI联合化疗、抗血管内皮生长因子单克隆抗体及免疫治疗在NSCLC治疗中的联合机制。此外,我们总结了将基于EGFR-TKI的联合治疗适应证扩展至EGFR突变阴性肺恶性肿瘤的临床试验。而且,正在研究探索具有良好生物相容性的新药的新策略。包裹非编码RNA的纳米颗粒及新剂型化疗备受关注,并在有效递送和稳定释放方面展现出前景。总体而言,由于在大多数情况下对EGFR-TKIs治疗产生耐药是不可避免的,因此需要进一步研究以阐明耐药的潜在机制,并评估和建立EGFR-TKI联合治疗方案,从而使NSCLC的治疗格局更加多样化。