ПРИОБРЕТЕННАЯ РЕЗИСТЕНТНОСТЬ К ИНГИБИТОРАМ ТИРОЗИНКИНАЗЫ EGFR: ПУТИ ПРЕОДОЛЕНИЯ

• Format: Article
• Language: Russian
• Published: Remedium Group LLC 2017-11-01
• Series: Медицинский совет
• Subjects: non-small cell lung cancer; egfr; tyrosine kinase inhibitors of egfr; resistance; osimertinib
• Online Access: https://www.med-sovet.pro/jour/article/view/2164

Advances in the treatment of disseminated patients with non-small cell lung cancer are directly linked to targeted therapy. Patients with activating mutations in the gene for the receptor of epidermal growth factor  (EGFR) in appointing them in the first line EGFR tyrosine kinase inhibitors (EGFR TKI) of the first and second generations have a significant preference for immediate efficacy and time to progression. In addition, patients with a deletion in exon 19 of EGFR receiving afatinib, overall survival reached 30 months, which is statistically higher compared to standard chemotherapy. However, during the 10–12 months developing acquired resistance to targeted drugs. The main reason which in 60% of cases is a mutation Т790М. Osimertinib – TKI third-generation proved to be highly effective  in these  patients. To clarify the mechanism of resistance requires repeated molecular genetic testing. Thus, you need to re-biopsy the tumor, optimally from the source of progression. Unfortunately, it is not always possible and an alternative may be a liquid biopsy. Only such an individual approach can provide a choice of optimum treatment tactics and improve patient survival.