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表皮生长因子受体-酪氨酸激酶抑制剂在伴软脑膜转移的非小细胞肺癌中的治疗作用

Therapeutic role of EGFR - Tyrosine kinase inhibitors in non-small cell lung cancer with leptomeningeal metastasis.

作者信息

Jia Caiyan, Xu Qian, Zhao Lu, Kong Fanming, Jia Yingjie

机构信息

Department of Oncology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, PR China; National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, PR China.

Department of Oncology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, PR China; National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, PR China.

出版信息

Transl Oncol. 2024 Jan;39:101832. doi: 10.1016/j.tranon.2023.101832. Epub 2023 Nov 25.

Abstract

Leptomeningeal metastasis (LM) is a significant complication that advances fast and has a poor prognosis for patients with advanced non-small cell lung cancer (NSCLC) who have epidermal growth factor receptor (EGFR) mutations. Current therapies for LM are inconsistent and ineffective, and established techniques such as radiation, chemotherapy, and surgery continue to fall short of potential outcomes. Nonetheless, EGFR tyrosine kinase inhibitors (TKIs) exhibit potent anti-tumor activity and hold considerable promise for NSCLC patients with EGFR mutations. Thus, assessing EGFR-TKIs effectiveness in treating these central nervous system (CNS) problems is crucial. This review integrates current literature on the intracranial efficacy of EGFR-TKIs to explore the varying impacts of approved EGFR-TKIs in LM patients and the therapeutic possibilities presented by other EGFR-TKIs in development. To delineate the optimal clinical treatment strategy, further exploration is needed regarding the optimal sequencing of EGFR-TKIs and the selection of alternative therapy options following initial treatment failure with EGFR-TKIs.

摘要

软脑膜转移(LM)是晚期非小细胞肺癌(NSCLC)且具有表皮生长因子受体(EGFR)突变患者的一种严重并发症,进展迅速且预后不良。目前针对LM的治疗方法缺乏一致性且效果不佳,诸如放疗、化疗和手术等成熟技术仍无法达到潜在疗效。尽管如此,EGFR酪氨酸激酶抑制剂(TKIs)展现出强大的抗肿瘤活性,对于具有EGFR突变的NSCLC患者具有很大的前景。因此,评估EGFR-TKIs治疗这些中枢神经系统(CNS)问题的有效性至关重要。本综述整合了关于EGFR-TKIs颅内疗效的当前文献,以探讨已获批的EGFR-TKIs对LM患者的不同影响以及其他处于研发阶段的EGFR-TKIs所带来的治疗可能性。为了确定最佳临床治疗策略,需要进一步探索EGFR-TKIs的最佳用药顺序以及在EGFR-TKIs初始治疗失败后替代治疗方案的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3daf/10728707/61df131802a8/ga1.jpg

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