Zhou Qing, Zhao Hongyun, Lu Shun, Cheng Ying, Liu Ying, Zhao Mingfang, Yu Zhuang, Hu Chengping, Zhang Li, Yang Fan, Zhao Jun, Guo Renhua, Ma Rui, Du Yingying, Dong Xiaorong, Cui Jiuwei, Tan Daniel S W, Ahn Myung-Ju, Tsuboi Masahiro, Maggie Liu Si-Yang, Mok Tony S, Wu Yi-Long
Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
Department of Clinical Research, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China.
Lancet Reg Health West Pac. 2024 Dec 11;53:101260. doi: 10.1016/j.lanwpc.2024.101260. eCollection 2024 Dec.
Lung cancer is the most prevalent malignant tumour in the Asia-Pacific region. Non-small cell lung cancer (NSCLC) accounts for approximately 85% of lung cancers. Among these, the rate of mutations in Asian patients with lung adenocarcinoma is 40-60%. Third-generation EGFR tyrosine kinase inhibitors (EGFR-TKIs) have improved the clinical management of NSCLC with mutations, but resistance to these drugs remains a significant challenge. Despite numerous ongoing studies, there is no standardized consensus on managing resistance to third-generation EGFR-TKIs. This consensus integrates international guidelines on EGFR-TKI management, findings from clinical studies, and experiences from the Asia-Pacific region in addressing post-resistance. Detailed recommendations are provided for classification and progression patterns, clinical testing, and post-resistance treatment strategies related to third-generation EGFR-TKI resistance. The aim of these recommendations is to offer reference opinions for the standardized management of patients exhibiting resistance to third-generation EGFR-TKIs in clinical practice.
肺癌是亚太地区最常见的恶性肿瘤。非小细胞肺癌(NSCLC)约占肺癌的85%。其中,亚洲肺腺癌患者的突变率为40%-60%。第三代表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs)改善了对有该突变的NSCLC的临床管理,但对这些药物的耐药性仍然是一个重大挑战。尽管有许多正在进行的研究,但对于第三代EGFR-TKIs耐药的管理尚无标准化的共识。本共识整合了关于EGFR-TKI管理的国际指南、临床研究结果以及亚太地区应对耐药后的经验。针对与第三代EGFR-TKI耐药相关的分类和进展模式、临床检测以及耐药后治疗策略提供了详细建议。这些建议的目的是为临床实践中对第三代EGFR-TKIs表现出耐药性的患者的标准化管理提供参考意见。