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表皮生长因子受体(EGFR)突变型非小细胞肺癌患者的个性化护理:从早期到晚期疾病管理的全程指引

Personalized care for patients with EGFR-mutant nonsmall cell lung cancer: Navigating early to advanced disease management.

作者信息

Borgeaud Maxime, Olivier Timothée, Bar Jair, Saw Stephanie Pei Li, Parikh Kaushal, Banna Giuseppe Luigi, De Vito Claudio, Feldman Jill, Le Xiuning, Addeo Alfredo

机构信息

Oncology Department, University Hospital Geneva, Geneva, Switzerland.

Institute of Oncology, Chaim Sheba Medical Center, Ramat Gan, Israel.

出版信息

CA Cancer J Clin. 2025 Sep-Oct;75(5):387-409. doi: 10.3322/caac.70024. Epub 2025 Jul 17.

Abstract

The discovery of activating mutations in the epidermal growth factor receptor (EGFR) gene has revolutionized the management of lung cancer, enabling the development of targeted tyrosine kinase inhibitors (TKIs). These therapies offer improved survival and reduced side effects compared with conventional treatments. Recent advancements have significantly reshaped the treatment paradigm for EGFR-mutant non-small cell lung cancer. TKIs are now incorporated into the management of early stage and locally advanced disease, and phase 3 trials have explored combination strategies in metastatic settings. Although these intensified approaches improve progression-free survival, they come with increased toxicity and higher costs, underscoring the need for precise patient selection to maximize benefit. Emerging data on biomarkers, such as co-mutations and circulating tumor DNA, show promise for refining treatment decisions. In addition, significant progress in understanding resistance mechanisms to EGFR TKIs has broadened therapeutic options. This review provides a comprehensive overview of the current landscape of EGFR-mutant nonsmall cell lung cancer, highlighting recent breakthroughs and discussing strategies to optimize treatment based on the latest evidence.

摘要

表皮生长因子受体(EGFR)基因激活突变的发现彻底改变了肺癌的治疗方式,推动了靶向酪氨酸激酶抑制剂(TKIs)的研发。与传统治疗方法相比,这些疗法提高了生存率并减少了副作用。最近的进展显著重塑了EGFR突变型非小细胞肺癌的治疗模式。TKIs现在已被纳入早期和局部晚期疾病的治疗中,并且3期试验已经探索了转移性疾病的联合治疗策略。尽管这些强化治疗方法改善了无进展生存期,但它们伴随着更高的毒性和成本,这凸显了精确选择患者以最大化获益的必要性。关于生物标志物的新数据,如共突变和循环肿瘤DNA,有望优化治疗决策。此外,在理解EGFR TKIs耐药机制方面取得的重大进展拓宽了治疗选择。本综述全面概述了EGFR突变型非小细胞肺癌的当前状况,突出了最近的突破,并根据最新证据讨论了优化治疗的策略。

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