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早期非小细胞肺癌患者在完全手术切除后靶向表皮生长因子受体

Targeting the epidermal growth factor receptor following complete surgical resection in patients with early-stage non-small cell lung cancer.

作者信息

Shaverdashvili Khvaramze, Burns Timothy F

机构信息

Department of Medicine, Division of Hematology-Oncology, University of Pittsburgh Medical Center (UPMC) Hematology Oncology Fellowship Program, Pittsburgh, PA, USA.

Department of Medicine, Division of Hematology-Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

出版信息

Expert Opin Pharmacother. 2023 May-Aug;24(11):1283-1293. doi: 10.1080/14656566.2023.2218031. Epub 2023 May 27.

Abstract

INTRODUCTION

Activating mutations in the () gene are one of the most common targetable oncogenic drivers of non-small cell lung cancer (NSCLC). Osimertinib is a third-generation EGFR tyrosine kinase inhibitor (EGFR-TKI) that selectively inhibits EGFR-TKI sensitizing ( or ) and mutations and has superior CNS penetration. Osimertinib is approved in mutant stage IB-IIIA NSCLC following complete tumor resection.

AREAS COVERED

This review opinion article summarizes the pivotal studies that led to the approval of current adjuvant therapies in NSCLC with the primary focus on EGFR-TKI osimertinib and outlines the future strategies in the era of neoadjuvant immunotherapy and emerging novel roles of EGFR targeting therapies. The literature search has been performed using PubMed, Food and Drug Administration website, and Google search.

EXPERT OPINION

Osimertinib showed significant and clinically meaningful disease-free survival benefit compared to placebo in mutant stage IB-IIIA NSCLC following complete tumor resection. Whether this will lead to improvement in overall survival and the optimal length of treatment remain open questions and are much-debated topic in the lung cancer field.

摘要

引言

()基因中的激活突变是非小细胞肺癌(NSCLC)最常见的可靶向致癌驱动因素之一。奥希替尼是一种第三代表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI),可选择性抑制EGFR-TKI敏感(或)和突变,并具有出色的中枢神经系统穿透力。奥希替尼在完全切除肿瘤后的突变IB-IIIA期NSCLC中获得批准。

涵盖领域

本综述性观点文章总结了导致目前NSCLC辅助治疗获批的关键研究,主要聚焦于EGFR-TKI奥希替尼,并概述了新辅助免疫治疗时代的未来策略以及EGFR靶向治疗的新出现的作用。文献检索使用了PubMed、美国食品药品监督管理局网站和谷歌搜索。

专家意见

在完全切除肿瘤后的突变IB-IIIA期NSCLC中,与安慰剂相比,奥希替尼显示出显著且具有临床意义的无病生存获益。这是否会导致总生存期改善以及最佳治疗时长仍是悬而未决的问题,也是肺癌领域备受争议的话题。

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