EGFR突变阳性Ⅲ期非小细胞肺癌药物治疗的研究进展OA
Research Progress in Drug Therapy against EGFR Mutation-Positive Stage Ⅲ Non-Small Cell Lung Cancer
非小细胞肺癌(non-small cell lung cancer,NSCLC)是最常见的肺癌类型,占所有病例的 85%,其中初次诊断时约 20%~30%的患者为Ⅲ期.根据TNM分期,Ⅲ期NSCLC可进一步分为 ⅢA期、ⅢB期和ⅢC期,预后不容乐观,且是一组高度异质性疾病,临床通常根据患者能否接受根治性手术治疗,分为可切除、潜在可切除和不可切除 3类,治疗方式复杂多样.但随着肺癌精准靶向、免疫治疗及多学科团队模式的推广,既往Ⅲ期NSCLC中潜在可切或不可切的患者有可能通过术前靶向、免疫及化疗治疗来缩小肿瘤体积、降低肿瘤分期,从而获得手术治疗的机会.对于表皮生长因子受体(epidermal growth factor receptor,EGFR)突变阳性不可切除的患者,同步放化疗后EGFR酪氨酸激酶抑制剂巩固治疗较传统的单纯同步放化疗显著延长了无进展生存期和总生存期,且优于免疫巩固治疗,成为新的治疗标准.此外,靶向药物联合放疗的"去化疗"模式也正在积极探索中.多学科协作和精准治疗策略将进一步提升Ⅲ期EGFR突变NSCLC患者的临床获益.本文概述了当前针对EGFR突变阳性的Ⅲ期NSCLC治疗的研究进展,旨在为进一步临床实践提供新的思路.
Non-small cell lung cancer(NSCLC)is the most common type of lung cancer,accounting for 85%of all ca-ses.Approximately 20%~30%of patients are diagnosed with stage III disease at initial presentation.According to the TNM staging system,stage III NSCLC can be further divided into stage IIIA,IIIB,and IIIC,indicating a progressively poorer prog-nosis.Stage III NSCLC is a highly heterogeneous disease.Clinically,patients are usually classified into three categories based on their eligibility for radical surgery-resectable,potentially resectable,and unresectable-leading to complex and diverse treat-ment approaches.However,with the advancement of precise targeted therapy,immunotherapy,and the promotion of the multi-disciplinary team model in lung cancer treatment,some cases of stage III NSCLC that were previously considered potentially re-sectable or unresectable may now be eligible for surgical treatment.For patients with EGFR mutation-positive unresectable stage III NSCLC,consolidation therapy with EGFR-TKIs following concurrent chemoradiotherapy has significantly prolonged both pro-gression-free survival and overall survival compared with traditional concurrent chemoradiotherapy alone.It has also demonstrated superiority over immune consolidation therapy,thereby establishing itself as a new standard of care.In addition,the"chemotherapy-free"model,which combines targeted drugs with radiotherapy,is being actively explored.Multidisciplinary collaboration and precision treatment strategies will further improve clinical outcomes for patients with stage III EGFR-mutant NSCLC.This article summarizes the current research and re-cent advances in the treatment of EGFR mutation-positive stage III NSCLC,aiming to inform further clinical research.
刘畅;李鑫;周行
610054 成都,电子科技大学 医学院610041 成都,四川省肿瘤医院·研究所,四川省肿瘤临床医学研究中心,四川省癌症防治中心,电子科技大学附属肿瘤医院 肿瘤内科610041 成都,四川省肿瘤医院·研究所,四川省肿瘤临床医学研究中心,四川省癌症防治中心,电子科技大学附属肿瘤医院 肿瘤内科
医药卫生
Ⅲ期非小细胞肺癌EGFR突变酪氨酸激酶抑制剂靶向治疗免疫治疗
Stage Ⅲ non-small cell lung cancer(NSCLC)EGFR mutationTyrosine kinase inhibitor(TKI)Targeted therapyImmunotherapy
《肿瘤预防与治疗》 2026 (3)
224-233,10
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