EGFR-TKIs耐药后非小细胞肺癌免疫治疗的研究进展
Current status and exploration of immunologic combination therapy after EGFR-TKIs resistance in non-small cell lung cancer
投稿时间:2024-10-07  修订日期:2024-11-11
DOI:
中文关键词:  非小细胞肺癌  EGFR-TKIs  免疫治疗  EGFR-TKIs耐药
英文关键词:non-small cell lung cancer  EGFR-TKIs  immunotherapy  EGFR-TKIs resistance
基金项目:山东省中医药科技重点项目(2012Z31)-“基于Meta-16S微生物学技术的温针灸疗法对非小细胞肺癌患者肠道菌群多样性的影响及代谢机制研究”;2022-2024年青岛市临床重点专科攀登高峰学科计划(2022-10)
作者单位邮编
史志琦 山东中医药大学第一临床医学院 250014
赵丽丽 青岛大学附属青岛市海慈医院(青岛市中医医院) 
朱艺宸 青岛大学医学部中西医结合专业 
谢宇欣 山东中医药大学第一临床医学院 
田金 青岛大学附属青岛市海慈医院(青岛市中医医院) 
龙麟 青岛大学附属青岛市海慈医院(青岛市中医医院) 
肖军* 青岛大学附属青岛市海慈医院(青岛市中医医院) 266033
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中文摘要:
      表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor-tyrosine kinase inhibitors,EGFR-TKIs)是表皮生长因子受体(epidermal growth factor receptor,EGFR)突变的晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的标准一线治疗方案,EGFR-TKIs耐药严重影响患者预后,EGFR-TKIs耐药机制的探讨及后续治疗是当前研究的难点和重点。近年来,免疫检查点抑制剂在EGFR-TKIs耐药晚期NSCLC的治疗中展现出显著优势,本综述从EGFR-TKIs耐药NSCLC的免疫相关机制、免疫单药、免疫联合靶向、化疗、抗血管、双抗等治疗现状;并依据程序性细胞死亡因子配体1(programmed cell death-ligand 1,PD-L1)表达、肿瘤突变负荷(tumor mutation burden, TMB)、EGFR突变类型及代谢产物等指标预测选择EGFR耐药后的优势人群进行阐述,以期为EGFR-TKIs耐药治疗研究及临床提供参考。
英文摘要:
      Epidermal growth factor receptor tyrosine kinase inhibitors are the standard first-line treatment options for patients with advanced non-small cell lung cancer with epidermal growth factor receptor mutations.EGFR-TKIs resistance seriously affects the prognosis of patients, and the exploration of the mechanism of EGFR-TKIs resistance and the subsequent treatment are the difficulties and focuses of the current research. In recent years, immune checkpoint inhibitors have demonstrated significant advantages in the treatment of EGFR-TKIs-resistant advanced NSCLC. This review looks at the current status of EGFR-TKIs-resistant NSCLC in terms of immune-related mechanisms, immune therapy, immune-combination targeting, chemotherapy, anti-angiogenesis, and dual-antibiotic therapy; and predicts the choice of EGFR-tolerant NSCLC based on indicators such as programmed cell death factor ligand 1 expression, tumor mutational load, EGFR mutation We also predicted and selected the superior population after EGFR resistance based on the programmed cell death factor ligand 1 expression, tumor mutation load, EGFR mutation type and metabolites, etc. We elaborated the results with the aim of providing reference for the research and clinical of EGFR-TKIs resistance treatment.
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