| 柏 洪,陈余清.非小细胞肺癌表皮生长因子受体T790M突变的研究进展[J].中国肿瘤,2021,30(2):150-160. |
| 非小细胞肺癌表皮生长因子受体T790M突变的研究进展 |
| Research Progress on Epidermal Growth Factor Receptor Gene T790M Mutation in Non-small Cell Lung Cancer |
| 中文关键词 修订日期：2020-04-10 |
| DOI：10.11735/j.issn.1004-0242.2021.02.A008 |
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| 中文关键词: 非小细胞肺癌 表皮生长因子受体 表皮生长因子受体—酪氨酸激酶抑制剂 T790M突变 临床因素 奥希替尼 |
| 英文关键词:non-small cell lung cancer epidermal growth factor receptor epidermal growth factor receptor-tyrosine kinase inhibitor T790M mutation clinical features osimertinib |
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| 中文摘要: |
| 摘 要：临床工作中表皮生长因子受体—酪氨酸激酶抑制剂（epidermal growth factor receptor-tyrosine kinase inhibitor，EGFR-TKI）耐药的非小细胞肺癌（non-small cell lung cancer，NSCLC）患者须进行EGFR T790M突变的检测。由于多种原因一些患者无法通过组织再活检获得满意基因检测结果，而液体活检也存在敏感性较低等限制。探索与T790M突变状态相关的临床因素、提高T790M突变再活检的技术水平有助于实现EGFR-TKI耐药后的精准诊断。T790M突变的NSCLC患者首选三代EGFR-TKI奥希替尼，但仍会不可避免地出现耐药。该文对继发性T790M突变的发生、相关检测技术的优劣、临床因素、治疗选择、奥希替尼的耐药机制及对策等研究情况进行综述，希望为患者临床再活检策略及后续治疗的选择提供帮助。 |
| 英文摘要: |
| Abstract：In clinical practice，the detection of epidermal growth factor receptor(EGFR) gene T790M mutation is required in patients with non-small cell lung cancer(NSCLC) who are resistant to epidermal growth factor receptor-tyrosine kinase inhibitor(EGFR-TKI). Due to various reasons，some patients are unable to obtain genetic test results through tissue re-biopsy，and liquid biopsy also has limitations such as low sensitivity. Exploring clinical factors related to T790M mutation status and improving the re-biopsy techniques for T790M mutation can help to achieve accurate diagnosis after acquiring resistance to EGFR-TKI.The third-generation EGFR-TKI osimertinib is the first choice for NSCLC patients with T790M mutation though drug resistance is still inevitable. In this article，the development and detection of secondary T790M mutation，the related clinical factors，treatment options，the mechanism and countermeasures of drug resistance of osimertinib are reviewed to provide information for the selection of clinical re-biopsy strategies and subsequent treatment. |
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