References

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medalphabet-267

Research Article

Статьи

Немелкоклеточный рак легкого с активирующими мутациями EGFR: место таргетной терапии в эру иммуноонкологии

Non-small cell lung cancer with activating EGFR-mutations: place of targeted therapy in immuno-oncology era

Артамонова

Е. В.

Artamonova

E. V.

noemail@neicon.ru

ФГБУ «Национальный медицинский исследовательский центр онкологии имени Н.Н. Блохина» Минздрава РоссииРоссияRussian Oncological Scientific Centre n.a. N.N. BlokhinRussian Federation

2017

14082017

225

Диагностика и онкотерапия

1726

2017

Артамонова Е.В.

Artamonova E.V.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.med-alphabet.com/jour/article/view/267

В статье обсуждается место таргетной и иммунотерапии в лечении распространенного немелкоклеточного рака легкого с активирующими мутациями EGFR. По данным подгрупповых анализов и мета-анализа рандомизированных клинических исследований, ингибиторы контрольных точек иммунитета не имеют преимуществ перед химиотерапией у этой категории пациентов. Одним из важных факторов, объясняющих относительно более низкую эффективность анти-PD/PD-L1 - моноклональных антител при НМРЛ EGFRm, является низкая мутационная нагрузка, характерная для опухолей с драйверными мутациями. Напротив, таргетная терапия тирозинкиназными ингибиторами в этой популяции увеличивает выживаемость, обеспечивает очень высокую частоту объективного ответа и характеризуется быстротой наступления регрессий, что очень важно при симптомном течении заболевания и большой распространенности опухолевого процесса. Таким образом, стандартом терапии больных местнораспространенным или метастатическим НМРЛ EGFRm продолжают оставаться тирозинкиназные ингибиторы.

The article discusses the place of targeted and immunotherapy in the treatment of advanced non-small-cell lung cancer with activating EGFR mutations. According to subgroup analyzes and meta-analysis of randomized clinical trials, inhibitors of immunity control points have no advantage over chemotherapy in this category of patients. One of the important factors explaining the relatively lower efficacy of anti-PD/PD-L1 monoclonal antibodies in EGFRm NSCLC is the low mutation load characteristic for tumors with driver mutations. On the contrary, targeted therapy with tyrosine kinase inhibitors in this population increases survival rate, provides a very high frequency of objective response and is characterized by rapid regression, which is very important in the symptomatic course of the disease and the high prevalence of the tumor process. Thus, tyrosine kinase inhibitors continue to be the standard for the therapy of patients with locally distributed or metastatic NSCLC EGFRm.

немелкоклеточный рак легкогодрайверные мутациианти-PD/PD-L1 - препаратытирозинкиназные ингибиторы

non-small cell lung cancerdriver mutationsanti-PD/PD-L1 drugstyrosine kinase inhibitors

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The authors declare that there are no conflicts of interest present.