EGFR抑制剂耐药机制研究的新进展

表皮生长因子受体(EGFR)通路在肿瘤发生、发展过程中起到非常重要的作用，它已成为肿瘤分子治疗领域最主要的研究和开发靶点之一。目前有单克隆抗体与小分子受体酪氨酸激酶抑制剂两类EGFR抑制剂在临床治疗中取得成功。然而，该类药物在临床前研究及临床治疗中已经出现耐药现象。由于EGFR调节多种细胞功能，该耐药现象可能与多个传导通路紊乱有关，包括配体自分泌/旁分泌的产生、受体突变、下游信号蛋白的组成性活化以及旁路信号途径的激活。本文就EGFR抑制剂耐药机制的最新研究进展进行综述。     

EGFR单抗的耐药机制及食管癌治疗进展

表皮生长因子受体(EGFR)在多种上皮性肿瘤中过表达,其异常活化与恶性肿瘤的发生、发展密切相关。分子靶向药物EGFR单抗已经成功应用于头颈部鳞癌、结直肠癌等;但其耐药问题严重制约着临床疗效。近年来对EGFR单抗在肿瘤中的耐药机制、疗效相关的分子标志物及解决耐药策略的研究凸显重要;同时已有临床研究显示EGFR单抗在食管癌中也取得较好的临床疗效。     

表皮生长因子受体家族单克隆抗体耐药机制的研究进展

表皮生长因子受体(EGFR)家族广泛存在于体内各种细胞中,其异常活化与多种人类上皮组织肿瘤的发生、发展密切相关,因此已成为肿瘤治疗的重要靶点之一。目前靶向EGFR家族的药物包括小分子酪氨酸激酶抑制剂和单克隆抗体(简称单抗)类药物,特别是单抗类药物近年来在临床上获得了广泛的应用。但是,越来越多的临床资料表明,大量患者对这类药物表现出原发性耐药或获得性耐药。目前靶向EGFR家族单抗类药物产生耐药的原因主要包括:受体结构改变、血管生成、多种受体酪氨酸激酶的活化、EGFR的亚细胞定位、EGFR下游效应分子的持续激活和EGFR家族生长因子表达的上调等。本文就靶向EGFR家族单抗类药物耐药机制的研究进展进行综述。     

EGFR及EGF在鼻咽癌中的作用及临床意义

表皮生长因子受体(epidermal growth factor receptor,EGFR)及其配体表皮生长因子(epidermal growth factor,EGF)在肿瘤的生长和分化过程中起重要作用,EGFR过表达、失调或突变与许多上皮恶性肿瘤密切相关.EGFR与其相应配体EGF等结合后激活,继而活化一系列下游信号通路并产生众多的生物效应.     

非小细胞肺癌酪氨酸激酶抑制剂耐药后处理策略

<正>随着表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)在临床的广泛应用,耐药问题逐渐浮现,成为新的研究热点。大多数表皮生长因子受体(EGFR)突变阳性的非小细胞肺癌(NSCLC)患者在初始治疗大约6~12个月之后将出现继发性耐药,从而导致EGFR-TKI治疗失效。一、EGFR-TKI耐药1.原发性耐药:肿瘤对首次进行TKI药物治疗未出现响应,在症状改善、疾病进展和延长生存期等方面未获得明显提高,即为原发性耐药。2.继发性耐药:多数EGFR突变患者在接受     

肝细胞生长因子受体/表皮生长因子受体交互作用与肿瘤耐药

肝细胞生长因子受体(mesenchymal-epithelial transition factor, MET)通路在肿瘤发生过程中具有重要作用,包括促进细胞增殖、抑制细胞凋亡、促进肿瘤血管生成、促进肿瘤细胞迁移及侵袭、转移等多个过程,涉及质膜、胞内共作用因子及下游效应蛋白的协同作用.体内、外实验证实,MET与表皮生长因子受体(epithelial growth factor receptor, EGFR)之间存在复杂的交互作用,两者共同参与细胞增殖、细胞运动及下游信号通路活化等多种细胞生物学事件,其中一些与肿瘤发生、进展密切相关.MET有可能通过"置换"EGFR活性而参与EGFR抑制剂的耐药发生.文中综述了肝细胞生长因子(hepatocyte growth factor,HGF)-MET和EGFR通路在肿瘤发生、发展过程中的重要作用,讨论了两者交互作用引起EGFR抑制剂耐药的可能机制,在此基础上提出联合使用EGFR和MET靶向抑制剂在克服EGFR抑制剂获得性耐药方面的应用前景.     

EGFR/EGFRvⅢ促头颈肿瘤上皮-间质转移的研究

表皮生长因子受体(EGFR)属受体酪氨酸激酶生长因子受体家族,由原癌基因erb B1编码并翻译的蛋白。表皮生长因子受体三型突变(EGFRvⅢ)是EGFR的一种最常见突变体,EGFR和EGFRvⅢ在头颈肿瘤中广泛表达。其与相应的配体结合后主要通过Ras/Raf/丝裂原激活蛋白激酶的激酶/细胞外信号调节激酶/丝裂原活化蛋白激酶和磷脂酰肌醇3-激酶/蛋白激酶B信号通路,促进肿瘤细胞生长、调节细胞周期、诱导血管形成、加速肿瘤侵袭和转移、拮抗放、化疗效果,从而影响肿瘤的预后。     

非小细胞肺癌EGFR-TKI耐药预测生物标志物研究进展

随着对肿瘤发病机制及其生物学行为的深入研究,分子靶向治疗成为目前治疗非小细胞肺癌(non-small celllung cancer,NSCLC)最具前景的研究领域。其中表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor tyrosinekinase inhibitor,EGFR-TKI)可延长患者无进展生存期并明显提高患者生活质量,然而耐药已成为影响该类药物临床应用的最大障碍。因此对EGFR-TKI耐药机制的研究已成为关注的热点。现已发现其耐药可能与受体突变、细胞内信号转导相关蛋白、EGFR以外的TK受体介导的通路活化等有关。文中就NSCLC对EGFR-TKI耐药机制的最新研究进展进行综述。     

西妥昔单抗联合放化疗治疗中晚期恶性肿瘤的研究进展

表皮生长因子受体（EGFR）活化所触发的信号传导通路参与肿瘤生长的调控,EGFR在许多实体瘤中均有不同程度的表达,通过抑制EGFR信号传导通路的方法可控制肿瘤的发展。西妥昔单抗属于新型人鼠嵌合型IGg单克隆抗体,可与人的正常细胞及肿瘤细胞的表皮生长受体的胞外激酶特异性结合,竞争性抑制EGFR和其它配体的结合,从而阻断受体相关激酶的磷酸化作用,抑制细胞生长,诱导凋亡,达到控制肿瘤生长的目的。     

转移性结直肠癌靶向药物的耐药机制及中医药治疗策略

分子靶向治疗是转移性结直肠癌（mCRC）的主要治疗方法之一,联合化学疗法可使患者的总生存期（OS）、无进展生存期（PFS）显著获益。临床常用的分子靶向药物主要包括小分子信号传导抑制剂和大分子单克隆抗体。但靶向治疗后期产生的耐药问题成为临床上治疗的关键难题。研究表明,靶向药物耐药机制可能与多种因素相关,包括表皮生长因子受体（EGFR）、血管内皮生长因子（VEGF）、人表皮生长因子受体-2(HER2)等相关细胞信号通路异常以及肿瘤微环境改变等。近年来,研究发现中医药治疗在逆转靶向药物耐药方面颇有成效。因此,该文对CRC分子靶向治疗耐药机制以及中医药应对策略进行论述,并对逆转靶向耐药的中药及其有效成分进行探讨。     

转移性结直肠癌抗EGFR治疗耐药机制的研究进展

表皮生长因子受体(epidermal growth factor receptor,EGFR)是转移性结直肠癌(metastatic colorectal cancer, mCRC)的主要治疗靶点之一,然而抗EGFR治疗的耐药一直是亟待解决的临床难题。肿瘤细胞本身EGFR相关信号通路异常激活,基因组不稳定性等遗传学或表观遗传学改变是引发耐药最常见的机制,近期也有研究发现肿瘤微环境中细胞丰度和细胞因子的变化等也是引发抗EGFR治疗耐药的重要机制。我们将从肿瘤细胞和肿瘤微环境两个方面,对mCRC抗EGFR治疗的耐药机制进行综述。     

非小细胞肺癌分子靶向治疗的毒性反应研究进展

近年来,非小细胞肺癌的分子靶向治疗成为研究的热点,分子靶向治疗药物主要包括表皮生长因子受体 (epidermal growth factor receptor,EGFR)单克隆抗体、血管内皮生长因子受体(vascular endothelial growth factor receptor,VEGFR)单克隆抗体、表皮生长因子受体酪氨酸激酶抑制剂等。这些药物在临床上都取得了一定的疗效,同时也出现了皮疹、腹泻、高血压等若干毒性反应,还有一些新药,如索拉非尼、舒尼替尼、伏立诺他、范得它尼等,都有相关的毒性反应。分子靶向治疗毒性反应严重影响了患者的生活质量和服药的依从性。本文就非小细胞肺癌分子靶向药物的毒性反应及处理措施作一综述。     

EGFR突变的非小细胞肺癌耐药机制及其克服新策略

表皮生长因子受体(EGVR)突变的非小细胞肺癌(NSCLC)被列为一个与临床相关的、独特的肺癌亚群.虽然EGFR突变的肿瘤患者增加了对酪氨酸激酶抑制剂(TKI)的敏感性,但其耐药仍然是一个主要的临床问题.针对原发和获得性耐药不同的分子机制,包括应用第2代或第3代TKI,以及与EGFR下游信号通路抑制剂的组合用药等多项临...     

Epidermal growth factor receptor and bladder cancer

Muscle-invasive bladder cancer is a disease which causes significant morbidity and mortality. The two main forms of treatment for this disease include radical cystectomy and radical radiotherapy, but five year survival after treatment remains low at 40%. Many clinical and molecular risk factors have been shown to be associated with poor prognosis. One such factor is the expression of epidermal growth factor receptor (EGFR), which is overexpressed by many epithelial tumours, including bladder cancers. There are several methods of inhibiting the activity of EGFR and it may be that use of an anti-EGFR therapy, in combination with more conventional treatment, provides a method of improving the prognosis for muscle-invasive bladder cancer.     

EGFR抑制剂耐药机制的研究进展及治疗策略

EGFR是调节细胞内环境稳态的一种酪氨酸激酶,其与配体结合后可影响细胞增殖、凋亡、迁移、存活、血管生成和肿瘤发生等一系列复杂过程,EGFR抑制剂已逐渐应用于临床肿瘤治疗。但随着时间的推移,EGFR抑制剂靶向治疗出现了耐药现象。本文将对EGFR抑制剂的研究现状及耐药机制做一简短的概述,冀希为优化、整合EGFR靶向治疗提供参考。     

Therapies directed against epidermal growth factor receptor in aerodigestive carcinomas

Context  Malignancies arising from the aerodigestive epithelium, including lung, head and neck, and esophageal carcinomas, are the leading causes of cancer-related mortality worldwide. Given the biological importance of epidermal growth factor receptor (EGFR) in cancer development and progression, EGFR inhibitors have emerged as promising novel therapies. Objectives  To summarize the current status of EGFR inhibitors in aerodigestive carcinomas (ADCs), highlight ongoing research designed to optimize their therapeutic effectiveness, and consider the future role of these agents. Evidence Acquisition  Systematic MEDLINE search of English-language literature (1966-April 2007) performed using the terms EGFR, EGFR inhibitors, monoclonal antibodies, tyrosine kinase inhibitors, lung cancer, head and neck cancer, esophageal cancer, and EGFR predictive factors. Quality assessment of selected studies included clinical pertinence, with an emphasis on controlled study design, publication in peer-reviewed journals, adequate number of enrolled patients, objectivity of measurements, and techniques used to minimize bias. Evidence Synthesis  The role of EGFR in ADC pathogenesis has been extensively studied, and multiple EGFR inhibition strategies are under evaluation. Erlotinib, an EGFR tyrosine kinase inhibitor used as a single agent, and cetuximab, an anti-EGFR monoclonal antibody used in combination with radiation, have conferred survival benefit in 1 trial of patients with advanced non–small cell lung cancer (median survival, 6.7 vs 4.7 months; hazard ratio, 0.70; 95% confidence interval, 0.58-0.87; P < .001) and in 1 trial of patients with locally advanced head and neck squamous cell carcinoma (median survival, 49 vs 29.3 months; hazard ratio, 0.74; 95% confidence interval, 0.57-0.97; P = .03), respectively. However, other trials have not shown these degrees of improvement. EGFR inhibitors toxicities include rash, diarrhea, and hypomagnesemia. Somatic mutations and other molecular tumoral characteristics offer opportunities for treatment individualization and optimal patient selection for anti-EGFR therapy. Conclusions  EGFR is a promising therapeutic target in ADC. Further translational research is needed to optimize ways of inhibiting EGFR using single-agent or combination regimens and to identify patients who benefit the most from these therapies.      

Update of epidermal growth factor receptor-tyrosine kinase inhibitors in non-small-cell lung cancer

Lung cancer is the leading cause of cancer-related death in the world. Prior to the era of targeted therapy, platinum-based doublet chemotherapy was the first-line therapy of choice for patients with metastatic non-small-cell lung cancer (NSCLC). The availability of agents that target epidermal growth factor receptor (EGFR)-tyrosine kinase, as well as inhibitors against anaplastic lymphoma kinase (ALK) gene rearrangement or ROS-1 gene rearrangement product, has provided promising clinical benefits in specific subpopulations of NSCLC. At present, only first-generation EGFR-tyrosine kinase inhibitors (TKIs) (erlotinib and gefitinib) are available for clinical use. Second-generation irreversible EGFR-TKIs, such as afatinib, are still in clinical trials. In current clinical practice, EGFR-TKI is the first-line treatment of choice for metastatic NSCLC patients with tumor EGFR mutation or as salvage therapy in NSCLC patients who received systemic chemotherapy previously. Platinum-based doublet chemotherapy continues to be the standard of care for those treatment-naïve patients with EGFR wild -type tumor or unknown EGFR status. Even though all investigators agree with the use of EGFR-TKI as the first-line treatment in tumor EGFR-mutated patients, only 10–30% of NSCLC patients have mutated EGFR, and there was no obvious survival difference when EGFR-TKIs were used in a second-line setting versus a first-line treatment in EGFR-mutated patients. Thus, the molecular complexity of lung cancer emphasizes the need for optimizing treatment by seeking a more personalized approach to care, including searching for driver oncogenes, managing the emergence of resistance and overcoming that resistance, and optimizing the sequence of treatment. Numerous other novel targeted agents are now in clinical development, including new agents targeting novel pathways and those that may have the potential to overcome the limitations or resistance associated with currently available EGFR-TKIs. In this report, we review the clinical data of EGFR-TKIs as molecular-targeted therapies in NSCLC.     

上皮生长因子及其抗体对人癌细胞系生长的影响

本研究观察了上皮生长因子(EGF)抗EGF抗体和抗EGF受体抗体对3个目建的人胰腺癌细胞系(PC-1,PC-2,PC-3)和3个其它人癌细胞系(肺腺癌LETP,乳腺癌BCP37和胃腺癌SGL7901)生长的影响。结果表明:EGF仅对PC-1和LETP2个细胞系有轻度刺激生长的作用,对其它4个细胞系无明显作用。在有EGF存在的条件下,抗EGF抗体和抗EGF受体抗体对PC-1,LETP和SGL7901 3个细胞系有生长抑制作用。 用Northern核酸杂交技术研究表明这6个人癌细胞系中均有EGF受体mRNA的表达。结果表明:虽然这些细胞系中均有EGF受体的基因表达,但不一定对外源性EGF处理有反应。