唐勇, 乔贵宾. EGFR敏感突变Ⅱ~ⅢA期非小细胞肺癌治疗的研究新进展[J]. 中国肿瘤临床, 2019, 46(14): 707-711. DOI: 10.3969/j.issn.1000-8179.2019.14.812
引用本文: 唐勇, 乔贵宾. EGFR敏感突变Ⅱ~ⅢA期非小细胞肺癌治疗的研究新进展[J]. 中国肿瘤临床, 2019, 46(14): 707-711. DOI: 10.3969/j.issn.1000-8179.2019.14.812
Tang Yong, Qiao Guibin. Advances in the treatment of patients with stage Ⅱ-ⅢA non-small cell lung cancer and the EGFR mutation[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2019, 46(14): 707-711. DOI: 10.3969/j.issn.1000-8179.2019.14.812
Citation: Tang Yong, Qiao Guibin. Advances in the treatment of patients with stage Ⅱ-ⅢA non-small cell lung cancer and the EGFR mutation[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2019, 46(14): 707-711. DOI: 10.3969/j.issn.1000-8179.2019.14.812

EGFR敏感突变Ⅱ~ⅢA期非小细胞肺癌治疗的研究新进展

Advances in the treatment of patients with stage Ⅱ-ⅢA non-small cell lung cancer and the EGFR mutation

  • 摘要: 非小细胞肺癌(non-small cell lung cancer,NSCLC)为发病率最高的恶性肿瘤,Ⅱ~ⅢA期患者为潜在可根治人群。目前,围手术期的标准治疗为化疗,而表皮生长因子受体(epidermal growth factor receptor,EGFR)敏感突变的患者,新辅助或辅助靶向治疗可提高无病生存期(disease free survival,DFS),但是否能带来生存获益,尚未明确。ⅢA(N2)期NSCLC患者术后辅助放疗可带来生存获益,而不可手术切除的局部晚期NSCLC患者,同步放化疗后durvalumab维持治疗成为新标准。在驱动基因突变人群中的免疫治疗还有待于进一步探索,免疫治疗联合化疗可能为方向之一,而抗血管生成治疗不适宜在术后辅助治疗。

     

    Abstract: The incidence of non-small cell lung cancer (NSCLC) is the highest among malignant tumors. Stages Ⅱ to ⅢA patients are potentially treatable. Perioperative chemotherapy is the standard treatment for NSCLC; however, in patients with the EGFR mutation, neoadjuvant or adjuvant targeted therapy can improve disease-free survival (DFS). Despite this, the survival benefit is not clear. Postoperative adjuvant radiotherapy can enhance survival in patients with stage ⅢA (N2) NSCLC. Durvalumab maintenance therapy, after concurrent chemoradiotherapy, has become the new standard for patients with locally advanced and unresectable NSCLC. Immunotherapy requires additional investigation in patients with driver gene mutations, as does the combination of immunotherapy plus chemotherapy. Notably, anti-angiogenesis therapy has failed as a postoperative adjuvant therapy.

     

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