晚期非小细胞肺癌一线靶向治疗的研究进展.pdfVIP

2012年第39卷第19期 中国肿瘤临床 1449 晚期非小细胞肺癌一线靶向治疗的研究进展 姜战胜 潘战宇 综述 谢广茹 审校 摘要 肺癌是世界上发病率和死亡率最高的恶性肿瘤之一，其中85%以上为非小细胞肺癌（non-smallcelllungcancer， NSCLC）。目前，对于复发或转移性晚期NSCLC，化疗是必选治疗方法之一，但其疗效已进入平台期，近期和远期疗效均不甚理 想。靶向治疗作为20世纪90年代以来的肿瘤研究重点，在NSCLC的治疗中已占据重要地位。针对表皮生长因子受体的单克隆 抗体（西妥昔单抗）和小分子酪氨酸激酶抑制剂（厄洛替尼尼或吉非替尼）、血管内皮生长因子的单克隆抗体（贝伐珠单抗）以及针 对ALK阳性突变的抑制剂Crizotinib均已成为晚期NSCLC的一线治疗选择。其中，尤其以小分子酪氨酸激酶抑制剂疗效卓越，在 表皮生长因子受体突变的患者中，其单药应用的疗效优于一线化疗，有效率高达60%以上，可使患者的无疾病进展时间延长至10 个月。本文将就以上几种药物的相关临床研究对目前晚期NSCLC一线靶向治疗加以综述。 关键词 晚期 非小细胞肺癌 一线治疗 靶向治疗 doi:10.3969/j.issn.1000-8179.2012.19.016 Development of First-line Molecular-targeted Therapy for Advanced Non-small Cell Lung Cancer Zhansheng JIANG, Zhanyu PAN, Guangru XIE Correspondence to: Guangru XIE, E-mail: xieguangru@ 126 .com Department of Synergistic Chinese and Western Medicine, Tianjin Medical University Cancer Institute and Hospital; Key Laboratory of Cancer Prevention and Treatment of Tianjin City, Tianjin 300060, China Abstract Lung cancer is malignant tumor with the highest morbidity and mortality rates. Non-small cell lung cancer (NSCLC) occurs in over 85% of all lung cancer cases. Chemotherapy is the current primary treatment choice for recurrent and metastatic NSCLC. However, chemotherapy has reached a plateau in terms of short- and long-term response rates. Since the 1990s, intensified studies on molecular-targeted therapy have played an important role in NSCLC. At present, monoclonal antibodies (cetuximab) and small molecu- lar tyrosine kinase inhibitors (erlotinib or gefitinib) for epidermal growth factor receptor (EGFR), inhibitors for vascular endothelial growth factor (VEGF), monoclonal antibody (bevacizumab), and ALK positive mutations (Crizotinib) comprise the first-line treatment regimen for NSCLC. The efficacy of small molecule tyrosine kinase inhibitors is unambiguously ex