王晨, 陈淑珍. 非小细胞肺癌治疗药物EGFR-TKIs获得性耐药机制的研究进展J. 药学学报, 2019,54(8): 1364-1371. doi: 10.16438/j.0513-4870.2019-0089
引用本文: 王晨, 陈淑珍. 非小细胞肺癌治疗药物EGFR-TKIs获得性耐药机制的研究进展J. 药学学报, 2019,54(8): 1364-1371. doi: 10.16438/j.0513-4870.2019-0089
WANG Chen, CHEN Shu-zhen. Advances in the mechanisms of acquired resistance to EGFR-tyrosine kinase inhibitors in non-small cell lung cancerJ. Acta Pharmaceutica Sinica, 2019,54(8): 1364-1371. doi: 10.16438/j.0513-4870.2019-0089
Citation: WANG Chen, CHEN Shu-zhen. Advances in the mechanisms of acquired resistance to EGFR-tyrosine kinase inhibitors in non-small cell lung cancerJ. Acta Pharmaceutica Sinica, 2019,54(8): 1364-1371. doi: 10.16438/j.0513-4870.2019-0089

非小细胞肺癌治疗药物EGFR-TKIs获得性耐药机制的研究进展

Advances in the mechanisms of acquired resistance to EGFR-tyrosine kinase inhibitors in non-small cell lung cancer

  • 摘要: 肺癌在所有肿瘤中死亡率占第一位,其中非小细胞肺癌(NSCLC)占肺癌发病率的80%左右。近年来,分子靶向药物发展迅速,其中表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs)以表皮生长因子受体(EGFR)作为靶点,在治疗NSCLC患者中取得很好的疗效,目前有三代EGFR-TKIs在临床上使用,效果优于传统化疗,但是也都出现获得性耐药的问题。本文将获得性耐药机制的研究进展分为依赖EGFR通路和非依赖EGFR通路两部分作一综述。依赖EGFR通路主要介绍EGFR的基因突变,非依赖EGFR通路包括HER2的扩增、BIM缺失、HGF/c-MET通路的激活、IGF1R的活化、RAS突变、PTEN缺失、上皮-间充质转化、PUMA表达下调、IL-6和VEGF高表达,这些耐药机制相互联系,相互影响,使肿瘤细胞对EGFR-TKIs产生耐药。

     

    Abstract: Lung cancer ranks the first in the mortality rate among all cancers, and non-small cell lung carcinoma (NSCLC) accounts for about 80% of the incidence of lung cancer. In recent years, the drugs targeting specific molecules have been developed rapidly. The epidermal growth factor receptor-tyrosine kinase inhibitors (EGFRTKIs) have achieved good results in the treatment of patients with NSCLC. Currently, there are three generations of EGFR-TKIs, and the treatment outcome of these drugs surpasses traditional chemotherapies. However, the problems of acquired resistance remains in the course of treatment. In this review, research progress of the mechanisms of acquired resistance is divided into two parts:EGFR-dependent pathway and EGFR-independent pathway. The EGFR-dependent pathway mainly includes EGFR gene mutations, whereas the EGFR-independent pathways include HER2 amplification, BIM deletion, activation of HGF/c-Met pathway, activation of IGF1R, RAS mutation, PTEN deletion, epithelial-mesenchymal transition, PUMA loss, and high levels of expression of VEGF or IL-6. These interconnected mechanisms are linked with acquired resistance to EGFR-TKIs in NSCLC.

     

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