作者：栗博文1，2，刘丽萍1，2，李志凯2，3，吕文发2，4，张霄鹏2

单位：

1.063000河北省唐山市，华北理工大学研究生学院　2.050000河北省石家庄市，河北省人民医院胸外科3.050000河北省石家庄市，河北医科大学研究生学院　4.075000河北省张家口市，河北北方学院研究生学院

Units：

1.Graduate School of North China University of Science and Technology, Tangshan 063000, China2.Department of Thoracic Surgery, Hebei General Hospital, Shijiazhuang 050000, China3.Graduate School of Hebei Medical University, Shijiazhuang 050000, China4.Graduate School of Hebei North University, Zhangjiakou 075000, China

关键词：

癌，非小细胞肺；ErbB受体；表皮生长因子受体；突变；EGFR-TKIs；治疗结果；亚洲

Keywords：

Carcinoma, non-small-cell lung; ErbB receptors; Epidermal growth factor receptor; Mutation; EGFRTKIs;Treatment outcome; Asia

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.200

Funds：

河北省财政厅资助项目（2018034）

摘要：

肺癌（LC）的发病率和死亡率在全球所有的恶性肿瘤中位居前列。目前对于LC的治疗仍存在诸多的不确定性。其中非小细胞肺癌（NSCLC）约占LC的85%，值得关注的是其发病率在全世界范围内逐年增加。EGFR突变是NSCLC中最常见的致癌驱动因子。近年来，EGFR-TKIs逐渐成为EGFR突变阳性NSCLC患者的一线治疗药物。但目前很少有研究者比较不同EGFR-TKIs对不同EGFR突变阳性NSCLC患者的治疗效果，尤其是对亚洲患者的分析。本文回顾并分析了目前上市的5种EGFR-TKIs（第一代EGFR-TKIs：吉非替尼、厄洛替尼，第二代EGFR-TKIs：阿法替尼、达克替尼，第三代EGFR-TKIs：奥希替尼）治疗亚洲EGFR突变阳性NSCLC患者的效果。但是，在临床中，使用何种药物治疗EGFR突变阳性NSCLC患者，仍需要考虑其具体突变类型及不同地区的医疗报销政策。随着靶向治疗的不断发展，EGFR-TKIs序贯治疗也是一种可行的治疗策略，但仍然需要前瞻性研究进行评估。

Abstract：

The morbidity and mortality of lung cancer (LC) are among the highest among all malignant tumors in theworld. There are still many uncertainties about the treatment of LC. Among them, non-small cell lung cancer (NSCLC) accountsfor about 85% of LC, and it is worth noting that its incidence is increasing year by year worldwide. EGFR mutations are the mostcommon oncogenic drivers in NSCLC. In recent years, EGFR-TKIs have gradually become the first-line therapy for patients withEGFR mutation-positive NSCLC. However, few researchers have compared the therapeutic effects of different EGFR-TKIs ondifferent EGFR mutation-positive NSCLC patients, especially in Asian patients. This paper reviews and analyzes the efficacyof five EGFR-TKIs currently on the market (first-generation EGFR-TKIs: gefitinib, erlotinib, second-generation EGFR-TKIs:afatinib, dacomitinib, third-generation EGFR-TKIs: osimertinib) in the treatment of Asian patients with EGFR mutation-positiveNSCLC. However, in clinical practice, which drugs to use to treat EGFR mutation-positive NSCLC patients still need to considertheir specific mutation types and the medical reimbursement policies in different regions. With the continuous developmentof targeted therapy, sequential therapy with EGFR-TKIs is also a feasible treatment strategy, but still requires prospectiveevaluation.

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