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克唑替尼治疗晚期非小细胞肺癌研究进展

Research Advances of Crizotinib in Treatment of Advanced Non-small Cell Lung Cancer

  • 摘要: 在精准医疗的医学背景下,随着大量分子靶向药物的出现,非小细胞肺癌(non-small cell lung cancer, NSCLC)的治疗逐步走向个体化。EML4-ALK融合基因和口服多靶点(ALK/c-MET/ ROS1等)抑制剂克唑替尼(Crizotinib)的发现,为晚期NSCLC的靶向治疗推开了另一扇大门。多项研究显示,克唑替尼一线、二线或多线治疗ALK或ROS1等基因阳性的NSCLC疗效显著、安全。然而,大多数患者在治疗10~12月后会对克唑替尼产生获得性耐药,耐药机制复杂多样,克服耐药问题是目前面临的巨大挑战。本文通过总结克唑替尼在NSCLC患者中的治疗靶点、疗效、耐药发生机制及耐药后治疗研究进展,旨在为克唑替尼的临床用药及耐药后治疗提供一定的临床指导。

     

    Abstract: In the medical context of precision medicine, the treatment of non-small cell lung cancer(NSCLC) is gradually individualized with the advent of a large number of molecular targeted drugs. The discovery of EML4-ALK fusion gene and Crizotinib which is an oral multi-target (ALK/c-MET/ROS1) tyrosine kinase inhibitor has opened another door for targeted therapy on advanced NSCLC. A number of studies have demonstrated that Crizotinib as the first-line, second-line or multi-line treatment for the gene-related NSCLC including ALK or ROS1 positive NSCLC is safe and effective. However, acquired resistance to Crizotinib will develop after treatment for 10-12 months; the mechanisms of resistance are complex and diverse, so, overcoming the problem of resistance is a huge challenge now. In this paper, we summarize the therapeutic targets, efficacy, mechanisms of resistance and treatments after resistance to crizotinib in NSCLC; the aim is to provide some clinical guidance for the choice of molecular-targeted drug and treatments after drug resistance.

     

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