Epidermal growth factor receptor (EGFR) mutation and personalized therapy in advanced nonsmall cell lung cancer (NSCLC).
Epidermal growth factor receptor (EGFR) mutation and personalized therapy in advanced nonsmall cell lung cancer (NSCLC).
复制标题
DOI：
10.1007/s11523-013-0258-9
复制
发表时间：
2013-03
影响因子：
5.4
通讯作者：
Hagiwara, Koichi
中科院分区：
文献类型：
--
作者：
Kobayashi, Kunihiko;Hagiwara, Koichi
2009年前，非小细胞肺癌(NSCLC)是一种接受细胞毒性化疗的疾病，有效率为20%-35%，中位生存期(MST)为10-12月。2004年，人们发现在非小细胞肺癌中存在表皮生长因子受体(EGFR)基因的激活突变，并且具有EGFR突变的肿瘤对EGFR酪氨酸激酶抑制剂(TKI)高度敏感。4项III期研究(日本东北部(NEJ)002、日本西部胸科肿瘤组(WJTOG)3405，OPTIME和EUROTAC)前瞻性地比较了TKI(吉非替尼或厄洛替尼)与细胞毒性化疗作为EGFR突变非小细胞肺癌一线治疗的疗效。这些研究证实，从2009年到2011年，以TKI为主要终点的无进展生存期(PFS)显著长于标准化疗(危险比[HR] = 为0.16-0.49)。尽管NEJ002研究显示两组患者的总体存活率(OS)相同(HR = 为0.89)，但服用吉非替尼的患者的生活质量(QOL)维持得更长。总之，TKI应被视为晚期EGFR突变的NSCLC的标准一线治疗方案。自2009年以来，晚期非小细胞肺癌的治疗算法又引入了一个新的步骤。
Before 2009, nonsmall cell lung cancer (NSCLC) was one disease entity treated by cytotoxic chemotherapy that provided a response rate of 20–35 % and a median survival time (MST) of 10–12 months. In 2004, it was found that activated mutations of the epidermal growth factor receptor (EGFR) gene were present in a subset of NSCLC and that tumors with EGFR mutations were highly sensitive to EGFR tyrosine kinase inhibitors (TKI). Four phase III studies (North East Japan (NEJ) 002, West Japan Thoracic Oncology Group (WJTOG) 3405, OPTIMAL, and EUROTAC) prospectively compared TKI (gefitinib or erlotinib) with cytotoxic chemotherapy as first-line therapy in EGFR-mutated NSCLC. These studies confirmed that progression-free survival (PFS) with TKIs (as the primary endpoint) was significantly longer than that with standard chemotherapy (hazard ratio [HR] = 0.16–0.49) from 2009 to 2011. Although the NEJ 002 study showed identical overall survival (OS) between the arms (HR = 0.89), quality of life (QoL) was maintained much longer in patients treated with gefitinib. In conclusion, TKI should be considered as the standard first-line therapy in advanced EGFR-mutated NSCLC. Since 2009, a new step has been introduced in the treatment algorithm for advanced NSCLC.
登录
查看更多内容
影响因子：
158.5
作者：
Lynch, TJ;Bell, DW;Haber, DA
通讯作者：
Haber, DA
影响因子：
11.5
作者：
Morita, Satoshi;Okamoto, Isamu;Nukiwa, Toshihiro
通讯作者：
Nukiwa, Toshihiro
影响因子：
82.9
作者：
Kohno T;Ichikawa H;Totoki Y;Yasuda K;Hiramoto M;Nammo T;Sakamoto H;Tsuta K;Furuta K;Shimada Y;Iwakawa R;Ogiwara H;Oike T;Enari M;Schetter AJ;Okayama H;Haugen A;Skaug V;Chiku S;Yamanaka I;Arai Y;Watanabe S;Sekine I;Ogawa S;Harris CC;Tsuda H;Yoshida T;Yokota J;Shibata T
通讯作者：
Shibata T
影响因子：
51.1
作者：
Mitsudomi, Tetsuya;Morita, Satoshi;Fukuoka, Masahiro
通讯作者：
Fukuoka, Masahiro
影响因子：
11.2
作者：
Nagai, Y;Miyazawa, H;Hagiwara, K
通讯作者：
Hagiwara, K