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免疫检查点抑制剂治疗EGFR-TKIs耐药NSCLC的研究进展
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| 篇名： | 免疫检查点抑制剂治疗EGFR-TKIs耐药NSCLC的研究进展 |
| TITLE： | Research progress of immune checkpoint inhibitors in the treatment of EGFR-TKIs-resistant NSCLC |
| 摘要： | 表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）是治疗晚期非小细胞肺癌（NSCLC）的靶向药物，但长期使用会不可避免地出现耐药。EGFR-TKIs耐药后会改变肿瘤微环境，而EGFR-TKIs耐药的NSCLC患者可重新从免疫检查点抑制剂（ICIs）治疗中获益，但其肿瘤微环境变化较为复杂，疗效并不明确。本文通过对ICIs治疗EGFR-TKIs耐药NSCLC患者的临床研究进行综述发现，对于EGFR-TKIs耐药的NSCLC患者，ICIs单药治疗的效果并不明确，需要寻找其他相关生物标志物来筛选获益人群；ICIs+EGFR-TKIs存在潜在毒性，不建议临床选用；ICIs+化疗的疗效尚存在争议，建议临床谨慎应用；ICIs+抗血管内皮生长因子（VEGF）药物具有协同增效的作用，但可能会增加不良事件发生率；ICIs+化疗+抗VEGF药物治疗表现出不错的疗效，且不良事件发生率与单一化疗相当；淋巴细胞激活基因3抑制剂等ICIs新药还处于临床研究或临床前研究阶段，但其可能成为新的有前景的治疗方法。 |
| ABSTRACT： | Epidermal growth factor receptor tyrosine kinase inhibitors （EGFR-TKIs） are targeted drugs for the treatment of advanced non-small cell lung cancer （NSCLC）， but long-term use inevitably leads to drug resistance. Resistance to EGFR-TKIs can alter the tumor microenvironment， and patients with NSCLC resistant to EGFR-TKIs can regain the benefits of immune checkpoint inhibitors （ICIs）， but the changes in the tumor microenvironment are complex and the efficacy is unclear. This article reviews the clinical studies of ICIs in the treatment of EGFR-TKIs-resistant NSCLC， and finds that for patients with EGFR-TKIs-resistant NSCLC， the efficacy of ICIs as a single agent is unclear， and other relevant biomarkers need to be found to screen the beneficiary population. ICIs+EGFR-TKIs have potential toxicity and are not recommended for clinical use. There is controversy about the efficacy of ICIs+chemotherapy， and it is recommended to use it cautiously in clinical practice. ICIs+anti-vascular endothelial growth factor （VEGF） drug therapy has a synergistic effect， but may increase the incidence of adverse events. ICIs+chemotherapy+anti- VEGF drug have a synergistic effect and the incidence of adverse events is similar to that of chemotherapy. New ICIs such as lymphocyte activating gene 3 inhibitors are still in the clinical research stage or preclinical research stage， but they may be a new promising treatment. |
| 期刊： | 2025年第36卷第02期 |
| 作者： | 朱怡璇；汪洋；王彤敏 |
| AUTHORS： | ZHU Yixuan，WANG Yang，WANG Tongmin |
| 关键字： | 免疫检查点抑制剂；非小细胞肺癌；EGFR-TKIs；耐药 |
| KEYWORDS： | immune checkpoint inhibitors； non-small cell lung cancer； EGFR-TKIs； drug resistance |
| 阅读数： | 10 次 |
| 本月下载数： | 1 次 |
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