EGFR外显子20插入突变晚期非小细胞肺癌的治疗现状和突破  

Current Status and Breakthroughs in the Treatment of Advanced Non-Small Cell Lung Cancer with EGFR Exon 20 Insertion Mutations

作　　者：徐燕[1] 王孟昭[1] XU Yan;WANG Meng-zhao(Pulmonary and Critical Care Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院呼吸与危重症医学科,北京100730

出　　处：《中国合理用药探索》2023年第3期44-51,共8页Chinese Journal of Rational Drug Use

基　　金：中国医学科学院医学与健康科技创新工程项目(No.2021-I2M-C&TB-014);北京协和医院中央高水平医院临床科研专项(No.2022-PUMCH-A-128)。

摘　　要：肺癌是常见的恶性肿瘤之一,非小细胞肺癌(NSCLC)是肺癌最常见的组织学分型,约占肺癌的85%。表皮生长因子受体(EGFR)突变是NSCLC最常见的驱动基因,针对EGFR突变的靶向药物治疗给晚期NSCLC患者带来了显著的临床获益,表皮生长因子受体-酪氨酸激酶抑制剂(EGFR-TKIs)已成为治疗EGFR突变型晚期NSCLC患者的主要方法。EGFR外显子20插入(EGFRexon20ins)突变作为EGFR罕见突变中最常见的亚型,约占EGFR突变型NSCLC的4%~12%。因EGFRexon20ins突变体结构独特,EGFRexon20ins突变型NSCLC对1~3代EGFR-TKIs原发耐药,且预后差。近年来,随着对NSCLC认识的不断深入及新药研发的不断推进,针对EGFRexon20ins的靶向治疗取得了突破,其中舒沃替尼治疗EGFRexon20ins突变型NSCLC患者的客观缓解率(ORR)达59.8%,给患者带来了显著的临床受益。基于此,本研究概述了EGFRexon20ins突变型NSCLC患者的治疗现状、针对EGFRexon20ins突变型NSCLC患者的新药研发及其临床研究,以期为EGFRexon20ins突变型晚期NSCLC患者的临床治疗及新药研发提供一定的参考。Lung cancer is one of the common malignancies,of which non-small cell lung cancer(NSCLC is the most common histological subtype,accounting for approximately 85% of lung cancer.Epidermal growth factor receptor(EGFR) mutation is the most common type of driver genes mutations in NSCLC.Targeted therapy against EGFR mutations has provided significant clinical benefits to patients with advanced NSCLC,and epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKIs) have emerged as the main treatment for EGFR mutant advanced NSCLC.EGFR exon 20 insertion(EGFR exon20ins)mutations,the most common subtype of rare EGFR mutations,account for approximately 4% to 12% of EGFR mutant NSCLC.EGFR exon20ins mutant NSCLC are primarily resistant to 1st-3rd generation EGFR-TKIs due to their unique structure and the prognosis is poor.With further understanding of NSCLC and the continuous advancement of research and development of new drugs,breakthroughs have been achieved in targeted therapies against EGFR exon20ins in recent years,among which objective response rate(ORR) of sunvozertinib for patients with EGFR exon20ins mutant NSCLC reached 59.8%,bringing significant clinical benefits to patients.Based on this,this study provides an overview of the current treatment status of EGFR exon20ins mutant NSCLC patients,research and development of new drugs for EGFR exon20ins mutant NSCLC patients and their clinical studies,in order to provide certain reference for clinical treatment and research and development of new drugs for EGFR exon20ins mutant advanced NSCLC patients.

关 键 词：非小细胞肺癌 表皮生长因子受体 EGFR外显子20插入突变 表皮生长因子受体-酪氨酸激酶抑制剂 靶向药物治疗 

分 类 号：R734.2[医药卫生—肿瘤]