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肺癌是世界上发病率和死亡率最高的恶性肿瘤之一,其中85%以上为非小细胞肺癌(non-small cell lung cancer,NSCLC)。目前,对于复发或转移性晚期NSCLC,化疗是必选治疗方法之一,但其疗效已进入平台期,近期和远期疗效均不甚理想。靶向治疗作为20世纪90年代以来的肿瘤研究重点,在NSCLC的治疗中已占据重要地位。针对表皮生长因子受体的单克隆抗体(西妥昔单抗)和小分子酪氨酸激酶抑制剂(厄洛替尼尼或吉非替尼)、血管内皮生长因子的单克隆抗体(贝伐珠单抗)以及针对ALK阳性突变的抑制剂Crizotinib均已成为晚期NSCLC的一线治疗选择其中,尤其以小分子酪氨酸激酶抑制剂疗效卓越,在表皮生长因子受体突变的患者中,其单药应用的疗效优于一线化疗,有效率高达60%以上,可使患者的无疾病进展时间延长至10个月。本文将就以上几种药物的相关临床研究对目前晚期NSCLC一线靶向治疗加以综述。
Lung cancer is one of the most malignant tumors in the world with the highest morbidity and mortality, of which over 85% are non-small cell lung cancer (NSCLC). At present, for recurrent or metastatic advanced NSCLC, chemotherapy is one of the necessary treatment options, but its efficacy has entered a plateau, the short-term and long-term efficacy are less than ideal. Targeted therapy, the focus of oncology research since the 1990s, has played an important role in the treatment of NSCLC. Monoclonal antibodies against epidermal growth factor receptor (cetuximab) and small molecule tyrosine kinase inhibitors (erlotinib or gefitinib), monoclonal antibodies to vascular endothelial growth factor Bezac), and Crizotinib, an inhibitor of ALK-positive mutations, have all become first-line treatment options for advanced NSCLC, particularly with small-molecule tyrosine kinase inhibitors. In patients with a mutation in the epidermal growth factor receptor The efficacy of drug application is superior to the first-line chemotherapy, the effective rate of up to 60% or more, can make patients without disease progression time extended to 10 months. This article will be more than the above drug-related clinical studies on the current advanced NSCLC targeted therapy are reviewed.