免疫检查点抑制剂在EGFR突变非小细胞肺癌治疗应用的研究进展

目前,表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor-tyrosine kinase inhibitor,EGFR-TKI)是表皮生长因子受体(epidermal growth factor receptor,EGFR)基因敏感突变晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的一线治疗标准,但大多数患者最终出现获得性耐药。而针对免疫检查点程序性死亡受体(programmed death-1,PD-1)及其配体(PD-1 ligand,PD-L1)的抑制剂取得突破性进展,改变了NSCLC的治疗模式。多项研究显示,EGFR敏感突变NSCLC患者免疫检查点抑制剂疗效不佳,其可能机制主要包括EGFR敏感突变患者PD-L1的低表达、抑制性免疫微环境、低肿瘤突变负荷等等。通过对EGFR突变NSCLC患者特殊人群的选择,免疫检查点抑制剂与其他药物的联合应用,可能为EGFR敏感突变NSCLC患者的治疗带来希望。本文将对此进行综述,以期为表皮生长因子受体突变的非小细胞肺癌患者的治疗带来新的希望。

The application of immune checkpoint inhibitors in treating non-small cell lung cancer with EGFR mutation

Currently,epidermal growth factor receptor-tyrosine kinase inhibitors is the standard of first-line drugs for advanced non-small cell lung cancer(NSCLC)with EGFR gene mutations.However,most patients appear acquired resistance.Breakthroughs in inhibitors of programmed death-1(PD-1)and its ligand(PD-1 ligand,PD-L1)have rapidly changed the therapeutic model of NSCLC.Recent studies have shown that the efficacy of immune checkpoint inhibitors in EGFR-mutant NSCLC patients is not satisfactory,which might be caused by low PD-L1 expression,inhibitory immune microenvironment and low tumor mutation load.This review will elaborate the selection of NSCLC patients with EGFR mutation,the latest study progression of immune checkpoint inhibitors and its combined with other drugs,expecting to bring new hopes for the treatment of EGFR-mutant NSCLC patients.