甲状腺癌靶向药物的耐药机制  

Mechanisms of drug resistance to targeted drugs in thyroid cancer

作　　者：文昕云 吴珏堃[1] WEN Xinyun;WU Juekun(Department of Thyroid and Breast Surgery,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院甲状腺乳腺外科,广东广州510630

出　　处：《新医学》2025年第2期155-167,共13页Journal of New Medicine

基　　金：广东省自然科学基金(2018A030313671);广东省援疆科技特派员项目(KTPYJ2022006)。

摘　　要：对于分化良好以及早期甲状腺癌,通过手术、促甲状腺激素抑制治疗和放射性碘治疗等常规治疗方案,通常可以显著延长患者的总体生存期和无进展生存期,其预后可接近正常人群。对于无法手术切除或对放射性碘治疗无反应的晚期或未分化甲状腺癌,则通常需要全身治疗。传统的细胞毒性全身化学治疗或外照射放射治疗对这些患者的疗效甚微。近十年来,甲状腺癌的靶向治疗经历了快速发展期,尽管这些治疗方案取得了可喜的成果,但许多晚期甲状腺癌患者最终会因获得性耐药性而病情恶化。文章总结了甲状腺癌靶向药物的相关耐药机制以及克服耐药性的手段,以期为未来靶向治疗的临床实践提供参考,并指导后续研究方向。For well-differentiated and early-stage thyroid cancer,conventional treatment options such as surgery,thyroidstimulating hormone suppression therapy,and radioactive iodine therapy can usually significantly extend patients’overall survival and progression-free survival,with prognosis approaching that of the general population.In contrast,for advanced or undifferentiated thyroid cancer that cannot be surgically resected or is unresponsive to radioactive iodine treatment,systemic therapy is typically required.Traditional cytotoxic chemotherapy or external radiation therapy has limited efficacy in these patients.Over the past decade,targeted therapies for thyroid cancer have undergone rapid development.Despite these treatments yielding promising results,many patients with advanced thyroid cancer ultimately experience disease progression due to acquired resistance.In this paper,we summarize the mechanisms of resistance to targeted drugs in thyroid cancer and explore strategies to overcome resistance,aiming to provide reference for future clinical practice in targeted therapy and guide directions for subsequent research.

关 键 词：甲状腺癌 靶向治疗 耐药 丝裂原活化蛋白激酶 鼠类肉瘤病毒癌基因同源物B1 

分 类 号：R73[医药卫生—肿瘤]