Wang Xiaocen
School of Health Medicine, University of Sanya, Hainan, China.
Cancer Med. 2025 Feb;14(3):e70643. doi: 10.1002/cam4.70643.
Currently, the most effective oral targeted therapies for NSCLC in clinical practice are EGFR-TKIs. However, acquired drug resistance often leads to tumor progression and recurrence. EGFR overexpression and activation of its downstream pathways are primary contributors to both mutations in tumor cells and their development of drug resistance. Silibinin has been identified as a promising agent that can suppress EGFR signaling through multiple mechanisms. However, its poor water solubility and difficulty penetrating cell membranes result in rapid metabolism in vivo, and significantly affect its concentration in the blood.
We conducted a comprehensive search of the English PubMed database using various combinations of keywords, including "silibinin," "epidermal growth factor receptor," "phosphorylation," "chemotherapy," "nano," and "non-small cell lung cancer." The results were then filtered for their relevance and impact on current treatment paradigms.
This review presents a comprehensive exploration of the mechanisms underlying the EGFR autophosphorylation pathways that contribute to acquire drug resistance in. Additionally, this study delves into the potential of silibinin as a novel therapeutic agent for NSCLC, evaluating its advantages and limitations on the basis of existing research. The majority of the available data suggest that combining silibinin with first-generation TKIs would yield promising outcomes because of additive or synergistic effects, suggesting that optimizing the time and dosage of each of these treatments is crucial for achieving the best results.
The existing evidence is inadequate to endorse the clinical application of nano silibinin for NSCLC treatment. Developing multifunctional nanomedicines that incorporate silibinin, EGFR-TKIs, and other bioactive compounds is a recommended future strategy for NSCLC treatment.
目前,临床实践中用于非小细胞肺癌(NSCLC)的最有效口服靶向疗法是表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs)。然而,获得性耐药常常导致肿瘤进展和复发。EGFR的过表达及其下游通路的激活是肿瘤细胞发生突变及其产生耐药性的主要原因。水飞蓟宾已被确定为一种有前景的药物,它可以通过多种机制抑制EGFR信号传导。然而,其水溶性差且难以穿透细胞膜,导致在体内快速代谢,并显著影响其在血液中的浓度。
我们使用包括“水飞蓟宾”“表皮生长因子受体”“磷酸化”“化疗”“纳米”和“非小细胞肺癌”等关键词的各种组合,对英文PubMed数据库进行了全面检索。然后根据结果与当前治疗模式的相关性和影响进行筛选。
本综述全面探讨了导致获得性耐药的EGFR自磷酸化通路的潜在机制。此外,本研究深入探讨了水飞蓟宾作为NSCLC新型治疗药物的潜力,并根据现有研究评估了其优势和局限性。大多数现有数据表明,由于相加或协同作用,将水飞蓟宾与第一代TKIs联合使用将产生有前景的结果,这表明优化每种治疗的时间和剂量对于取得最佳效果至关重要。
现有证据不足以支持纳米水飞蓟宾在NSCLC治疗中的临床应用。开发包含水飞蓟宾、EGFR-TKIs和其他生物活性化合物的多功能纳米药物是NSCLC治疗未来推荐的策略。