PD-1/PD-L1抑制剂在EGFR-TKIs治疗失败的非小细胞肺癌中的研究进展  

Progress in PD-1/PD-L1 inhibitors in the EGFR-mutant non-small cell lung cancer with EGFR-TKIs failure

作　　者：周玉玲 张永昌[2] 廖德华[3] 杨农[2] ZHOU Yu-ling;ZHANG Yong-chang;LIAO De-hua;YANG Nong(University of South China,Hengyang Hunan 421001;Department of Medical Oncology,Lung Cancer and Gastrointestinal Unit,Hunan Cancer Hospital,Changsha 410013;Department of Pharmacy,Hunan Cancer Hospital,Changsha 410013)

机构地区：[1]南华大学,湖南衡阳421001 [2]湖南省肿瘤医院肺胃肠内科,长沙410013 [3]湖南省肿瘤医院药学部,长沙410013

出　　处：《中南药学》2021年第10期2104-2110,共7页Central South Pharmacy

基　　金：湖南省自然科学基金(No.2020JJ3025);吴阶平基金会临床药学科研专项(No.320.6750.2020-04-34);湖南省医学会医学科研基金(No.HMA202001005)。

摘　　要：非小细胞肺癌(NSCLC)是世界上死亡率最高的恶性肿瘤。表皮生长因子受体(EGFR)属于ERBB/HER酪氨酸激酶受体家族成员。在NSCLC中,20%左右的人群有EGFR突变。在EGFR突变阳性患者中,EGFR酪氨酸激酶抑制剂(EGFR-TKIs)能明显地改善患者的预后,延长生存时间,因而是该类人群的首选治疗方案,但是使用EGFR-TKIs治疗的患者最终仍然会发展成耐药,目前对于耐药后的患者仍然没有标准的后线治疗方案。程序性细胞死亡蛋白-1(PD-1)及其配体(PD-L1)抑制剂是通过解除免疫抑制激活免疫系统来发挥抗肿瘤效应。基于PD-1/PD-L1抑制剂及EGFR-TKIs两类药物的抗肿瘤机制的不同,有必要了解PD-1/PD-L1抑制剂在EGFR-TKIs治疗失败患者中的疗效。本文从目前PD-1/PD-L1抑制剂在EGFR-TKIs耐药患者中的治疗现状予以综述,并展望未来的治疗选择。Non-small cell lung cancer(NSCLC)is the most common cause of cancer associated mortality.The epidermal growth factor receptor(EGFR)belongs to the ERBB/HER family of tyrosine kinase receptors,and EGFR mutation occurrs in approximately 20%of NSCLC patients.EGFR tyrosine kinase inhibitors(EGFR-TKIs)have been proved to be first-line treatment in EGFR-mutated NSCLC and markedly improved response rates,and overall survival.However,patients with EGFR mutation eventually develop EGFR-TKIs resistance without standard regime in subsequent treatment.Programmed death-1(PD-1)or programmed death-ligand 1(PD-L1)inhibitors via blocking T cell immunosuppressive signals may induce anti-tumor effect.Based on different anti-tumor mechanisms,the efficacy of PD-1/PD-L1 inhibitor is worthy of investigation in EGFR-TKIs resistance patients.This article reviewed the clinical efficacy and research progression of PD-1/PD-L1 inhibitors and predicted future treatment direction in EGFR-TKIs resistance lung cancer patients.

关 键 词：非小细胞肺癌 EGFR-TKIs耐药 免疫治疗 PD-1/PD-L1抑制剂 

分 类 号：R96[医药卫生—药理学]