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关于基于表皮生长因子受体(EGFR)的疗法作为非小细胞肺癌(NSCLC)癌细胞死亡原因的新思考。

Novel considerations on EGFR-based therapy as a contributor to cancer cell death in NSCLC.

作者信息

Peng Weiwei, Yao Chengyun, Pan Qin, Zhang Zhi, Ye Jinjun, Shen Bo, Zhou Guoren, Fang Ying

机构信息

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.

出版信息

Front Oncol. 2023 Feb 23;13:1120278. doi: 10.3389/fonc.2023.1120278. eCollection 2023.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1498/9995697/9c48135b8197/fonc-13-1120278-g001.jpg

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