{"success":true,"data":{"id":172,"title":"NSCLC\u4e28\u5965\u5e0c\u66ff\u5c3c\u8010\u836f\u673a\u5236\u603b\u7ed3\u53ca\u6700\u65b0\u89e3\u51b3\u65b9\u6848","summary":"\u672c\u6587\u7cfb\u7edf\u603b\u7ed3\u4e86\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\uff08NSCLC\uff09\u4e2d\u4e09\u4ee3EGFR-TKI\u5965\u5e0c\u66ff\u5c3c\u7684\u8010\u836f\u673a\u5236\u53ca\u6700\u65b0\u89e3\u51b3\u65b9\u6848\u3002\u8010\u836f\u673a\u5236\u5206\u4e3a\u5728\u9776\u8010\u836f\uff08\u5982EGFR C797S\u3001G724S\u7a81\u53d8\uff09\u548c\u8131\u9776\u8010\u836f\uff08\u5982MET\u6269\u589e\u3001RET\u878d\u5408\uff09\uff0c\u4e00\u7ebf\u4e0e\u540e\u7ebf\u6cbb\u7597\u7684\u8010\u836f\u673a\u5236\u5206\u5e03\u4e0d\u540c\u3002\u6587\u7ae0\u57fa\u4e8e2020 ASCO\u7814\u7a76\u6570\u636e\uff0c\u8be6\u7ec6\u5206\u6790\u4e86\u4e0d\u540c\u8010\u836f\u673a\u5236\u5bf9\u5e94\u7684\u6cbb\u7597\u7b56\u7565\uff0c\u5305\u62ec\u8054\u5408\u7528\u836f\uff08\u5982\u5965\u5e0c\u66ff\u5c3c+MET\u6291\u5236\u5242\uff09\u3001\u7b2c\u56db\u4ee3EGFR\u6291\u5236\u5242\uff08\u5982BLU-945\uff09\u53ca\u9488\u5bf9\u8868\u578b\u8f6c\u5316\uff08\u5982SCLC\u8f6c\u5316\uff09\u7684\u5316\u7597\u65b9\u6848\u3002\u540c\u65f6\u4ecb\u7ecd\u4e862021 ASCO\u516c\u5e03\u7684\u65b0\u836fAmivantamab+lazertinib\u548cPatritumab Deruxtecan\u7684\u4e34\u5e8a\u6570\u636e\uff0c\u4e3a\u5965\u5e0c\u66ff\u5c3c\u8010\u836f\u540e\u6cbb\u7597\u63d0\u4f9b\u5168\u9762\u6307\u5bfc\u3002","highlights":["\u5965\u5e0c\u66ff\u5c3c\u8010\u836f\u673a\u5236\u5206\u5728\u9776\u8010\u836f\uff08\u5982C797S\u7a81\u53d8\uff09\u548c\u8131\u9776\u8010\u836f\uff08\u5982MET\u6269\u589e\uff09\uff0c\u4e00\u7ebf\u6cbb\u7597\u66f4\u6613\u53d1\u751f\u8131\u9776\u8010\u836f\u3002","\u8010\u836f\u540e\u9700\u6839\u636e\u8fdb\u5c55\u72b6\u6001\uff08\u5c40\u90e8\/\u5e7f\u6cdb\u8f6c\u79fb\uff09\u9009\u62e9\u5c40\u90e8\u6cbb\u7597\u6216\u7cfb\u7edf\u6cbb\u7597\uff0c\u5e76\u63a8\u8350\u57fa\u56e0\u68c0\u6d4b\u660e\u786e\u8010\u836f\u539f\u56e0\u3002","\u9488\u5bf9C797S\u7a81\u53d8\uff1a\u987a\u5f0f\u7a81\u53d8\u53ef\u7528\u5e03\u52a0\u66ff\u5c3c+\u897f\u59a5\u6614\u5355\u6297\uff0c\u53cd\u5f0f\u7a81\u53d8\u53ef\u7528\u4e00\u4ee3+\u4e09\u4ee3EGFR-TKI\u8054\u5408\u6cbb\u7597\u3002","\u65b0\u836fAmivantamab\uff08EGFR\/MET\u53cc\u6297\uff09+Lazertinib\u53caADC\u836f\u7269U3-1402\u5728\u591a\u79cd\u8010\u836f\u673a\u5236\u4e2d\u663e\u793a\u7597\u6548\u3002"],"faq":[{"question":"\u8fd9\u7bc7\u6587\u7ae0\u8ba8\u8bba\u4e86\u54ea\u4e9b\u4e3b\u9898\uff1f","answer":"\u5965\u5e0c\u66ff\u5c3c\u8010\u836f, EGFR\u7a81\u53d8, C797S\u7a81\u53d8, MET\u6269\u589e, \u8868\u578b\u8f6c\u5316, \u8054\u5408\u6cbb\u7597, \u7b2c\u56db\u4ee3EGFR\u6291\u5236\u5242, \u4e2a\u4f53\u5316\u6cbb\u7597, NSCLC, \u9776\u5411\u6cbb\u7597"},{"question":"\u6587\u7ae0\u6838\u5fc3\u89c2\u70b9\u662f\u4ec0\u4e48\uff1f","answer":"\u5173\u6ce8\u6211\u4eec\uff5c\u7cbe\u51c6\u533b\u7597\u7684\u201c\u6df1\u79d1\u666e\u201d\u5728\u665a\u671f\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\uff08NSCLC\uff09\u7684\u6cbb\u7597\u4e2d\uff0c\u4e34\u5e8a\u533b\u751f\u5e38\u5e38\u4f1a\u9047\u5230\u8fd9\u6837\u7684\u56f0\u60d1\uff0c\u5965\u5e0c\u66ff\u5c3c\u8010\u836f\u540e\u600e\u4e48\u529e\uff1f\u5965\u5e0c\u66ff\u5c3c\u4f5c\u4e3a\u4e09\u4ee3EGFR-TKIs\uff0c\u514b\u670d\u4e86\u4e00\u4e8c\u4ee3EGFR-TKIs\u6cbb\u7597\u8fdb\u5c55\u540e\u5e38\u89c1\u7684\u8010\u836f\u673a\u5236\u2014\u2014T790M\u7a81\u53d8\uff0c\u6781\u5927\u5730\u63d0\u9ad8\u4e86\u60a3\u8005\u7684\u751f\u5b58\u83b7\u76ca\u3002\u800c\u5965\u5e0c\u66ff\u5c3c\u4e5f\u96be\u9003\u8010\u836f\u7684\u5bbf\u547d\uff0c\u5176\u8010\u836f\u540e\u7684\u5904\u7406\u5bf9\u4e8e\u540e\u7eed\u751f\u5b58\u83b7\u76ca\u7684\u5ef6\u957f\u81f3\u5173\u91cd\u8981\u3002 \u5c0f\u7f16\u5728\u8fd9\u91cc\u603b\u7ed3\u5e76\u6574\u7406\u5965\u5e0c\u66ff\u5c3c\u7684\u8010\u836f\u673a\u5236\u548c\u6700\u65b0\u7684\u89e3\u51b3\u65b9\u6848\uff0c\u7ed9\u4e34\u5e8a"}],"keywords":"\u5965\u5e0c\u66ff\u5c3c\u8010\u836f, EGFR\u7a81\u53d8, C797S\u7a81\u53d8, MET\u6269\u589e, \u8868\u578b\u8f6c\u5316, \u8054\u5408\u6cbb\u7597, \u7b2c\u56db\u4ee3EGFR\u6291\u5236\u5242, \u4e2a\u4f53\u5316\u6cbb\u7597, NSCLC, \u9776\u5411\u6cbb\u7597","content":"\u5173\u6ce8\u6211\u4eec\uff5c\u7cbe\u51c6\u533b\u7597\u7684\u201c\u6df1\u79d1\u666e\u201d\u5728\u665a\u671f\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\uff08NSCLC\uff09\u7684\u6cbb\u7597\u4e2d\uff0c\u4e34\u5e8a\u533b\u751f\u5e38\u5e38\u4f1a\u9047\u5230\u8fd9\u6837\u7684\u56f0\u60d1\uff0c\u5965\u5e0c\u66ff\u5c3c\u8010\u836f\u540e\u600e\u4e48\u529e\uff1f\u5965\u5e0c\u66ff\u5c3c\u4f5c\u4e3a\u4e09\u4ee3EGFR-TKIs\uff0c\u514b\u670d\u4e86\u4e00\u4e8c\u4ee3EGFR-TKIs\u6cbb\u7597\u8fdb\u5c55\u540e\u5e38\u89c1\u7684\u8010\u836f\u673a\u5236\u2014\u2014T790M\u7a81\u53d8\uff0c\u6781\u5927\u5730\u63d0\u9ad8\u4e86\u60a3\u8005\u7684\u751f\u5b58\u83b7\u76ca\u3002\u800c\u5965\u5e0c\u66ff\u5c3c\u4e5f\u96be\u9003\u8010\u836f\u7684\u5bbf\u547d\uff0c\u5176\u8010\u836f\u540e\u7684\u5904\u7406\u5bf9\u4e8e\u540e\u7eed\u751f\u5b58\u83b7\u76ca\u7684\u5ef6\u957f\u81f3\u5173\u91cd\u8981\u3002 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\u5728\u4e86\u89e3\u5965\u5e0c\u66ff\u5c3c\u7684\u8010\u836f\u673a\u5236\u4e4b\u524d\uff0c\u6211\u4eec\u5148\u4e86\u89e3\u4e0b\u5965\u5e0c\u66ff\u5c3c\u83b7\u6279\u7684\u9002\u5e94\u75c7\u53ca\u4e34\u5e8a\u4e0a\u4f7f\u7528\u7684\u4e09\u79cd\u60c5\u51b5\uff1a01\u57fa\u4e8eAURA\u7814\u7a76\uff0cFDA\/NMPA\u6279\u51c6\u5965\u5e0c\u66ff\u5c3c\u7528\u4e8e\u7ecfEGFR-TKI\u6cbb\u7597\u5931\u8d25\u7684\u643a\u5e26T790M\u7a81\u53d8\u7684\u8f6c\u79fb\u6027NSCLC\u4e8c\u7ebf\u6cbb\u7597\u300202\u57fa\u4e8eFLAURA\u7814\u7a76\uff0cFDA\/NMPA\u6279\u51c6\u5965\u5e0c\u66ff\u5c3c\u7528\u4e8eEGFR\u654f\u611f\u7a81\u53d8\u8f6c\u79fb\u6027NSCLC\u4e00\u7ebf\u6cbb\u7597\uff1b\u8be5\u7814\u7a76\u4e2d\u5965\u5e0c\u66ff\u5c3c\u6cbb\u7597\u603b\u751f\u5b58\u671f\uff08OS\uff09\u8d85\u8fc73\u5e74\uff0838.6\u4e2a\u6708\uff09\uff0cNCCN\u6307\u5357\u5c06\u5965\u5e0c\u66ff\u5c3c\u4f5c\u4e3aEGFR\u7a81\u53d8\u665a\u671fNSCLC\u4e00\u7ebf\u6cbb\u7597\u9996\u9009\u63a8\u8350\u300203\u57fa\u4e8eADAURA\u7814\u7a76\uff0cFDA\/NMPA\u6279\u51c6\u5965\u5e0c\u66ff\u5c3c\u7528\u4e8eEGFR\u654f\u611f\u7a81\u53d8\u65e9\u671fNSCLC\uff08IB-IIIA\u671f\uff09\u624b\u672f\u5207\u9664\u540e\u7684\u8f85\u52a9\u6cbb\u7597\u3002\u5728\u665a\u671fNSCLC\u4e2d\uff0c\u5965\u5e0c\u66ff\u5c3c\u65e2\u53ef\u7528\u4e8e\u521d\u8bcaEGFR\u654f\u611f\u7a81\u53d8\u60a3\u8005\u7684\u4e00\u7ebf\u6cbb\u7597\uff08first-line\uff09\uff0c\u4e5f\u53ef\u7528\u4e8e\u4e00\u4e8c\u4ee3EGFR-TKIs\u8010\u836f\u540eT790M\u7a81\u53d8\u60a3\u8005\u7684\u540e\u7ebf\u6cbb\u7597\uff08later-line\uff09\u3002\u6709\u7814\u7a76\u8868\u660e\uff0c\u540e\u7ebf\u4f7f\u7528\u5965\u5e0c\u66ff\u5c3c\u7ea610\u4e2a\u6708\u5de6\u53f3\u4f1a\u53d1\u751f\u8010\u836f\u3002\u7814\u7a76\u53d1\u73b0\uff0c\u6cbb\u7597\u73af\u5883\uff08\u4e00\u7ebf vs. \u540e\u7ebf\uff09\u53ef\u80fd\u5f71\u54cd\u5965\u5e0c\u66ff\u5c3c\u7684\u8010\u836f\u673a\u5236\uff0c\u4e3b\u8981\u8868\u73b0\u4e3a\u8010\u836f\u673a\u5236\u7684\u5206\u5e03\u4e0d\u540c\u3002\u5206\u5b50\u8010\u836f\u673a\u5236\u53ef\u5206\u4e3a\uff1a\u5728\u9776\u8010\u836f\uff08on-target\uff09\u548c\u8131\u9776\u8010\u836f\uff08off-target\uff09\u4e24\u79cd\uff0c\u5728\u9776\u8010\u836f\u6307EGFR\u901a\u8def\u83b7\u5f97\u6027\u8010\u836f\uff0c\u8131\u9776\u8010\u836f\u6307\u65c1\u8def\u6fc0\u6d3b\u9014\u5f84\u30022020 ASCO\u4f1a\u8bae\u516c\u5e03\u4e86\u4e00\u9879\u5173\u4e8e\u5965\u5e0c\u66ff\u5c3c\u8010\u836f\u673a\u5236\u7814\u7a76\uff0c\u5c3d\u7ba1\u6837\u672c\u91cf\u4e0d\u5927\uff0c\u4f46\u662f\u8fc4\u4eca\u4e3a\u6b62\u91c7\u7528\u914d\u5bf9\u7ec4\u7ec7\u6837\u672c\u8fdb\u884c\u5965\u5e0c\u66ff\u5c3c\u8010\u836f\u5206\u6790\u7684\u6700\u5927\u89c4\u6a21\u7814\u7a76\uff1a\u7814\u7a76\u7eb3\u516562\u4f8bEGFR\u7a81\u53d8NSCLC\u4e14\u7ecf\u5965\u5e0c\u66ff\u5c3c\u6cbb\u7597\u8010\u836f\u7684\u60a3\u8005\uff0c\u53d6\u6cbb\u7597\u524d\u540e\u7684\u914d\u5bf9\u80bf\u7624\u7ec4\u7ec7\u8fdb\u884c\u5206\u6790\uff0c\u5176\u4e2d27\u4f8b\u4e00\u7ebf\u91c7\u7528\u5965\u5e0c\u66ff\u5c3c\u6cbb\u7597\uff08\u4e00\u7ebf\u961f\u5217\uff09\uff0c35\u4f8b\u540e\u7ebf\u91c7\u7528\u5965\u5e0c\u66ff\u5c3c\u6cbb\u7597\uff08\u540e\u7ebf\u961f\u5217\uff09\uff0c\u4e00\u7ebf\u961f\u5217\u4e2d\uff0c\u5965\u5e0c\u66ff\u5c3c\u6cbb\u7597\u7684\u4e2d\u4f4d\u505c\u836f\u65f6\u95f4\uff08mTTD\uff09\u4e3a13.6\u4e2a\u6708\uff0c\u6570\u636e\u622a\u6b62\u65f6\u670919\u4f8b\uff0870%\uff09\u60a3\u8005\u5b58\u6d3b\uff0c\u540e\u7ebf\u961f\u5217\u4e2d\uff0cmTTD\u4e3a15.2\u4e2a\u6708\uff0c\u6570\u636e\u622a\u6b62\u65f6\u670925\u540d\uff0871%\uff09\u60a3\u8005\u5b58\u6d3b\u3002 \u8010\u836f\u673a\u5236\u5206\u6790\uff08\u4e00\u7ebf vs. \u540e\u7ebf\uff09 \u4e00\u7ebf\u5965\u5e0c\u66ff\u5c3c\u8010\u836f\u961f\u5217\u4e2d\uff0c41%\uff0811\/27\uff09\u7684\u60a3\u8005\u5b58\u5728\u5df2\u77e5\u7684\u83b7\u5f97\u6027\u8010\u836f\u673a\u5236\uff1a 1\u8131\u9776\u8010\u836f\u5728\u4e00\u7ebf\u8010\u836f\u4e2d\u5360\u591a\u6570\uff0c\u4e3b\u8981\u673a\u5236\u6709MET\u6269\u589e\u3001MET\u7a81\u53d8\uff08H1094Y\uff09 \u3001KRAS\u7a81\u53d8\uff08G12A\uff09 \u3001BRAF\u878d\u5408\u3001RET\u878d\u5408\u7b49\uff1b2\u8be5\u7814\u7a76\u4e2d\u5728\u9776\u8010\u836f\u673a\u5236\u6709EGFR\u6269\u589e\u3001G724S\uff0c\u5176\u4e2dG724S\u662f\u7ecf\u9274\u5b9a\u7684\u5728\u9776\u8010\u836f\u673a\u5236\uff0c\u5176\u4ed6\u7814\u7a76\uff08\u5982FLAURA\uff09\u62a5\u9053\u7684\u6709C797S\u3001L718Q\/V\u7a81\u53d8\u7b49\uff1b3\u591a\u8fbe15%\u7684\u60a3\u8005\u5728\u4e00\u7ebf\u5965\u5e0c\u8010\u836f\u540e\u4f1a\u53d1\u751f\u5411\u9cde\u764c\uff08Squamous\uff09\u3001\u5c0f\u7ec6\u80de\u764c\uff08SCLC\uff09\u6216\u591a\u5f62\u6027\u764c\uff08pleomorphic\uff09\u7684\u8868\u578b\u8f6c\u5316\u3002\u540e\u7ebf\u5965\u5e0c\u66ff\u5c3c\u8010\u836f\u961f\u5217\u4e2d\uff0c71%\uff0825\/35\uff09\u7684\u60a3\u8005\u5b58\u5728\u5df2\u77e5\u7684\u83b7\u5f97\u6027\u8010\u836f\u673a\u5236\uff1a 1\u5728\u9776\u8010\u836f\u673a\u5236\u5360\u591a\u6570\uff0c\u6700\u5e38\u89c1\u7684\u4e3aEGFR C797\u7a81\u53d8\uff08C797S = 9 \u3001C797G = 1\uff09\uff0c\u6bd4\u4f8b\u7ea6\u4e3a29%\uff1b2\u8131\u9776\u8010\u836f\u5305\u62ec\uff1aBRAF\u878d\u5408\u3001MET ex14\u7a81\u53d8\u548cKRAS G12D\u7a81\u53d8\uff0c\u53d1\u751f\u5728T790M\u4e22\u5931\u7684\u60a3\u8005\u4e2d\uff0c\u800cALK\u878d\u5408\u3001ERBB2 Y772_A775dup\u53d1\u751f\u5728T790M\u4fdd\u7559\u7684\u60a3\u8005\u4e2d\uff1b314%\u7684\u60a3\u8005\u5728\u540e\u7ebf\u5965\u5e0c\u8010\u836f\u540e\u53d1\u751f\u9cde\u764c\u548cSCLC\u7684\u8868\u578b\u8f6c\u5316\u3002\u5965\u5e0c\u66ff\u5c3c\u4e0d\u540c\u7ebf\u6570\u8010\u836f\u673a\u5236\u5bf9\u6bd4\uff082020 ASCO\u58c1\u62a5\uff1a9028\uff09\u8010\u836f\u673a\u5236\u5c0f\u7ed3\/\/\u5173\u4e8e\u8010\u836f\u673a\u5236\u672a\u660e\uff08Unknown\uff09\u4e0a\u56fe\u53ef\u4ee5\u770b\u51fa\uff0c\u5de6\u56fe\u7070\u8272\u90e8\u5206\u7684\u6bd4\u4f8b\u660e\u663e\u5927\u4e8e\u53f3\u56fe\u3002\u7814\u7a76\u663e\u793a\uff1a\u4e00\u7ebf\u5965\u5e0c\u66ff\u5c3c\u8010\u836f\u540e\u7ea659%\u7684\u60a3\u8005\u627e\u4e0d\u5230\u660e\u786e\u7684\u8010\u836f\u673a\u5236\uff0c\u800c\u540e\u7ebf\u5965\u5e0c\u66ff\u5c3c\u8010\u836f\u7ea626%\u7684\u60a3\u8005\u6ca1\u6709\u660e\u786e\u7684\u8010\u836f\u673a\u5236\u3002\u8fd9\u7c7b\u673a\u5236\u672a\u660e\u7684\u60a3\u8005\u4e2d\uff0c\u8010\u836f\u6027\u53ef\u80fd\u662f\u7531\u8868\u89c2\u9057\u4f20\u4fee\u9970\u3001\u86cb\u767d\u8868\u8fbe\u53d8\u5316\u6216\u65b0\u7684\u57fa\u56e0\u7ec4\u6539\u53d8\u5bfc\u81f4\uff0c\u6b64\u5916\uff0c\u514b\u9686\u8fdb\u5316\u548c\u80bf\u7624\u5f02\u8d28\u6027\u4e5f\u5728\u9776\u5411\u6cbb\u7597\u8010\u836f\u4e2d\u53d1\u6325\u91cd\u8981\u4f5c\u7528\u3002\u672a\u6765\u8fd8\u9700\u8054\u5408\u591a\u79cd\u68c0\u6d4b\u65b9\u6cd5\u4ee5\u53ca\u591a\u56e0\u7d20\u7efc\u5408\u5206\u6790\u7814\u7a76\u6765\u660e\u786e\u8fd9\u4e9b\u672a\u77e5\u7684\u8010\u836f\u673a\u5236\u3002\/\/\u4e0d\u540c\u8010\u836f\u673a\u5236\u7684\u5206\u6790\u76f8\u8f83\u4e8e\u5176\u4ed6\u8010\u836f\u673a\u5236\uff0cEGFR\u901a\u8def\u83b7\u5f97\u6027\u7a81\u53d8\u4e0e\u5965\u5e0c\u66ff\u5c3c\u66f4\u957f\u7684\u6cbb\u7597\u65f6\u95f4\u548c\u66f4\u957f\u7684OS\u76f8\u5173\uff08mTTD\uff1a18.0\u4e2a\u6708 vs. 13.2\u4e2a\u6708\uff0cP=0.04; mOS\uff1a\u672a\u8fbe\u5230 vs. 29\u4e2a\u6708\uff0cP\uff1c0.001\uff09\u3002\u4e0e\u9776\u5411\u5206\u5b50\u8010\u836f\u7684\u60a3\u8005\u76f8\u6bd4\uff0c\u8868\u578b\u8f6c\u6362\u7684\u60a3\u8005\u4f7f\u7528\u5965\u5e0c\u66ff\u5c3c\u6cbb\u7597\u7684\u65f6\u95f4\u548c\u751f\u5b58\u671f\u66f4\u77ed\u3002 \u660e\u786e\u8010\u836f\u540e\u7ec4\u7ec7\u5b66\u7c7b\u578b\u5bf9\u5206\u6790\u8010\u836f\u673a\u5236\u81f3\u5173\u91cd\u8981\u3002\u5bf9\u4e0d\u540c\u8868\u578b\u8f6c\u5316\u6837\u672c\u7684\u5206\u5b50\u68c0\u6d4b\u53d1\u73b0\uff0c\u4e0e\u5148\u524d\u7814\u7a76\u62a5\u9053\u4e00\u81f4\uff0c\u53d1\u751fSCLC\u8f6c\u5316\u7684\u60a3\u8005\uff0c\u5728\u5965\u5e0c\u66ff\u5c3c\u6cbb\u7597\u524d\u6837\u672c\u4e2d\u5747\u5df2\u53d1\u73b0TP53\u548cRB1\u57fa\u56e0\u7684\u9884\u5148\u6539\u53d8\uff0c\u800c\u53d1\u751f\u9cde\u764c\u8f6c\u5316\u7684\u60a3\u8005\u8868\u73b0\u51fa\u76f8\u5f53\u5927\u7684\u57fa\u56e0\u7ec4\u590d\u6742\u6027\uff1a\u83b7\u5f97\u6027PIK3CA\u7a81\u53d8\u3001\u67d3\u8272\u4f533q\u6269\u589e\u548cFGF\u6269\u589e\u3002 \u503c\u5f97\u6ce8\u610f\u7684\u662f\uff0c\u8131\u9776\u8010\u836f\u5728\u4e00\u7ebf\u961f\u5217\u4e2d\u53d1\u751f\u7387\u9ad8\u4e8e\u540e\u7ebf\u961f\u5217\uff08P=0.01\uff09\uff0c\u8868\u660e\u4e00\u7ebf\u4f7f\u7528\u5965\u5e0c\u66ff\u5c3c\u66f4\u6613\u53d1\u751f\u8131\u9776\u8010\u836f\u3002\u9664\u6b64\u4e4b\u5916\uff0c\u521d\u59cbEGFR\u654f\u611f\u7a81\u53d8\u3001\u5965\u5e0c\u66ff\u5c3c\u6cbb\u7597\u65f6\u95f4\u548c\u6cbb\u7597\u7ebf\u4e5f\u4f1a\u5f71\u54cd\u51fa\u73b0\u7684\u8010\u836f\u673a\u5236\u3002\u56e0\u6b64\uff0c\u8bc6\u522b\u5965\u5e0c\u66ff\u5c3c\u7684\u8010\u836f\u673a\u5236\u5bf9\u4e8e\u5f00\u53d1\u8054\u5408\u6cbb\u7597\u65b9\u6848\u6216\u65b0\u4e00\u4ee3EGFR-TKIs\u81f3\u5173\u91cd\u8981\uff0c\u540c\u65f6\uff0c\u4e86\u89e3\u5e76\u5206\u6790\u5965\u5e0c\u66ff\u5c3c\u7684\u8010\u836f\u673a\u5236\u6709\u52a9\u4e8e\u4e2a\u4f53\u5316\u6cbb\u7597\u53ca\u75be\u75c5\u7ba1\u7406\u3002\u5965\u5e0c\u66ff\u5c3c\u8010\u836f\u540e\u6cbb\u7597\u7b56\u7565\u6839\u636e\u75be\u75c5\u8fdb\u5c55\u72b6\u6001\u8fdb\u884c\u6cbb\u7597\u5965\u5e0c\u66ff\u5c3c\u8010\u836f\u540e\u53ef\u5148\u6839\u636e\u75be\u75c5\u8fdb\u5c55\u72b6\u6001\uff0c\u9488\u5bf9\u6027\u8fdb\u884c\u5904\u7406\u3002\u975e\u5c0f\u7ec6\u80de\u80ba\u764cNCCN\u6307\u5357\uff082021.V5\uff09\u4e2d\u5bf9\u5965\u5e0c\u66ff\u5c3c\u8010\u836f\u540e\u7684\u63a8\u8350\u6839\u636e\u6709\u65e0\u75c7\u72b6\u548c\u8f6c\u79fb\u60c5\u51b5\u7ed9\u4e88\u76f8\u5e94\u7684\u6cbb\u7597\u65b9\u6848\u3002 1\uff09\u51fa\u73b0\u4ee5\u4e0b\u4e09\u79cd\u60c5\u51b5\u7684NSCLC\u60a3\u8005\uff0c\u53ef\u8003\u8651\u6839\u6cbb\u6027\u5c40\u90e8\u6cbb\u7597\uff08\u624b\u672f\u6216\u7acb\u4f53\u5b9a\u5411\u653e\u7597\uff09\uff0c\u540c\u65f6\u7ee7\u7eed\u5965\u5e0c\u66ff\u5c3c\u6cbb\u7597\uff1a \u65e0\u75c7\u72b6\u7684\u8fdb\u5c55\uff1b \u6709\u75c7\u72b6\u7684\u8111\u8f6c\u79fb\uff08\u914d\u5408\u8111\u8f6c\u79fb\u5904\u7406\uff0c\u5982\u5168\u8111\u653e\u7597\u3001\u66ff\u83ab\u5511\u80fa\u7b49\uff09\uff1b \u6709\u75c7\u72b6\u7684\u5b64\u7acb\u6027\u8f6c\u79fb\u7076\uff083-5\u4e2a\u8f6c\u79fb\u7076\uff09\uff1b 2\uff09\u5bf9\u4e8e\u6709\u75c7\u72b6\u7684\u591a\u53d1\u75c5\u7076\u8f6c\u79fb\u7684\u60a3\u8005\uff0c\u6761\u4ef6\u5141\u8bb8\u60c5\u51b5\u4e0b\u53ef\u8fdb\u884c\u7ec4\u7ec7\u6d3b\u68c0\uff0c\u6392\u9664SCLC\u8f6c\u5316\u53ef\u80fd\u3002\u82e5\u672a\u53d1\u751f\u8868\u578b\u8f6c\u5316\uff0c\u53ef\u66f4\u6362\u4e3a\u521d\u59cb\u7cfb\u7edf\u6cbb\u7597\u65b9\u6848\u5982\u5316\u7597\u65b9\u6848\u6216\u963f\u6cd5\u66ff\u5c3c+\u897f\u59a5\u6614\u5355\u6297\u3002\u975e\u5c0f\u7ec6\u80de\u80ba\u764cNCCN\u6307\u5357\uff082021.V5\uff09\uff1a\u5965\u5e0c\u66ff\u5c3c\u8010\u836f\u540e\u6cbb\u7597\u57fa\u56e0\u68c0\u6d4b\u660e\u786e\u8010\u836f\u539f\u56e0\uff0c\u9488\u5bf9\u6027\u6cbb\u7597\u65e0\u8bba\u4e00\u7ebf\u8fd8\u662f\u540e\u7ebf\u4f7f\u7528\u5965\u5e0c\u66ff\u5c3c\u6cbb\u7597\u8010\u836f\u7684\u60a3\u8005\uff0c\u90fd\u53ef\u884c\u57fa\u56e0\u68c0\u6d4b\uff0c\u53d6\u539f\u53d1\u7076\u8fdb\u5c55\u7ec4\u7ec7\u3001\u8f6c\u79fb\u7076\u6216\u5916\u5468\u8840\u6837\u672c\u9001\u68c0\uff0c\u660e\u786e\u5177\u4f53\u8010\u836f\u539f\u56e0\uff0c\u8fdb\u884c\u76f8\u5e94\u7684\u4e2a\u4f53\u5316\u6cbb\u7597\u3002\/\/EGFR\u901a\u8def\u83b7\u5f97\u6027\u8010\u836fC797S\u7a81\u53d8\u4e00\u7ebf\u5965\u5e0c\u66ff\u5c3c\u8010\u836f\uff0c\u8010\u836f\u540e\u901a\u5e38\u4e0d\u4f1a\u51fa\u73b0T790M\u7a81\u53d8\uff0c\u4f46\u4f1a\u51fa\u73b0C797S\u7684\u5355\u53d1\u7a81\u53d8\uff0cFLAURA\u7814\u7a76\u62a5\u9053\u8fd9\u4e00\u8010\u836f\u673a\u5236\u53d1\u751f\u7387\u7ea68%\u3002C797S\u5355\u7a81\u53d8\u5bf9\u4e00\u4ee3EGFR-TKIs\u654f\u611f\uff0c\u9488\u5bf9\u4e00\u7ebf\u5965\u5e0c\u8010\u836f\u643a\u5e26C797S\u5355\u7a81\u53d8\u7684\u60a3\u8005\uff0c\u53ef\u66f4\u6362\u4e3a\u4e00\u4ee3EGFR-TKIs\u836f\u7269\u3002\u540e\u7ebf\u5965\u5e0c\u66ff\u5c3c\u8010\u836f\uff0cC797S\u662f\u6700\u5e38\u89c1\u7684EGFR\u901a\u8def\u8010\u836f\u673a\u5236\uff0c\u5e38\u4e0eT790M\u5171\u5b58\u3002\u7814\u7a76\u663e\u793a\uff0cC797S\u548cT790M\u7a81\u53d8\u7684\u7ed3\u6784\u5173\u7cfb\u53ef\u4ee5\u5206\u4e3a\u987a\u5f0f\uff08cis\uff09\u548c\u53cd\u5f0f\uff08trans\uff09\u4e24\u79cd\uff0c\u82e5\u4e24\u8005\u4f4d\u4e8eEGFR\u7684\u540c\u4e00\u6761\u7b49\u4f4d\u57fa\u56e0\u4e0a\u5373\u4e3a\u987a\u5f0f\uff0c\u4f4d\u4e8e\u4e0d\u540c\u7684\u7b49\u4f4d\u57fa\u56e0\u4e0a\u5373\u4e3a\u53cd\u5f0f\u3002\u5927\u591a\u6570\u60c5\u51b5\u4e0b\uff0cC797S\u548cT790M\u5448\u987a\u5f0f\u7a81\u53d8\uff0898%\uff09\uff0c\u5bf9\u4e00\u4e8c\u4e09\u4ee3EGFR-TKIs\u5747\u8010\u836f\uff0c\u800c\u5c11\u6570\u60c5\u51b5\u4e0b\uff0c\u4e24\u8005\u5448\u53cd\u5f0f\u7a81\u53d8\uff082%\uff09\uff0c\u591a\u9879\u7814\u7a76\u8868\u660e\uff0c\u53cd\u5f0f\u7a81\u53d8\u5bf9\u4e00\u4ee3\u8054\u5408\u4e09\u4ee3EGFR-TKI\u6709\u6548\uff08\u5982\u5409\u975e\u66ff\u5c3c+\u5965\u5e0c\u66ff\u5c3c\uff09\u3002\u9488\u5bf9\u987a\u5f0f\u6784\u578b\uff0c2020 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ARMS-PCR\u68c0\u6d4b\u65b9\u6cd5\u660e\u786e\uff0c\u63a8\u8350\u4f7f\u7528\u9ad8\u901a\u91cf\u6d4b\u5e8f\uff08NGS\uff09\u68c0\u6d4b\u65b9\u6cd5\u6765\u9274\u522b\u3002C797S\u57fa\u56e0\u7a81\u53d8\u60c5\u51b5\uff08\u5355\u7a81\u53d8\u3001\u4e0eT790M\u6784\u578b\uff09\u53ca\u6cbb\u7597\u53f2\u5bf9C797S\u7684\u5f71\u54cd\u53ca\u6cbb\u7597\u5176\u4ed6EGFR\u901a\u8def\u83b7\u5f97\u6027\u8010\u836f\u7a81\u53d8\u4e00\u7ebf\u5965\u5e0c\u66ff\u5c3c\u8010\u836f\u540e\uff0c\u8fd8\u53ef\u80fd\u51fa\u73b0EGFR 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DeruxtecaPatritumab 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2021 ASCO|\u805a\u7126\u80ba\u764c\u53ca\u5b9e\u4f53\u7624\u7cbe\u51c6\u8bca\u7597\u8fdb\u5c55\u8868\u578b\u8f6c\u5316\u5927\u90e8\u5206\u53d1\u751fSCLC\u8f6c\u5316\u60a3\u8005\u4fdd\u7559\u4e86\u539f\u6709\u80ba\u817a\u764c\u7684\u57fa\u56e0\u7a81\u53d8\u548cSCLC\u7684\u57fa\u56e0\u7279\u5f81\uff0c\u5982TP53\u3001RB1\u3001PIK3CA\u7b49\uff0c\u60a3\u8005\u4e00\u65e6\u53d1\u751fSCLC\u8f6c\u5316\uff0c\u75be\u75c5\u5e38\u5e38\u8fdb\u5c55\u8f83\u5feb\uff0c\u9884\u540e\u6b20\u4f73\uff0c\u4e2d\u4f4d\u751f\u5b58\u671f6.0-10.9\u4e2a\u6708\u3002\u53ef\u66f4\u6362\u4e3a\u6807\u51c6SCLC\u5316\u7597\u65b9\u6848\u6216\u6807\u51c6SCLC\u5316\u7597\u65b9\u6848+\u5965\u5e0c\u66ff\u5c3c\u6cbb\u7597\u3002 \u76ee\u524d\u56fd\u5185\u6709\u591a\u4e2a\u5965\u5e0c\u66ff\u5c3c\u8010\u836f\u540e\u76f8\u5173\u7684\u4e34\u5e8a\u8bd5\u9a8c\u53ef\u4ee5\u53c2\u52a0\uff1a\u5b89\u9f99\u57fa\u56e0\u9488\u5bf9NSCLC\u5f00\u53d1\u4e86\u4e00\u7cfb\u5217NGS\u68c0\u6d4b\u4ea7\u54c1\uff0c\u53ef\u7b5b\u67e5\u5965\u5e0c\u66ff\u5c3c\u6cbb\u7597\u8fdb\u5c55\u540e\u4e3b\u8981\u7684\u8010\u836f\u673a\u5236\uff0c\u63d0\u4f9b\u4e2a\u4f53\u5316\u6cbb\u7597\u65b9\u6848\u53ca\u4e34\u5e8a\u8bd5\u9a8c\u4fe1\u606f\uff0c\u63d0\u9ad8\u60a3\u8005\u83b7\u76ca\u53ef\u80fd\u6027\u3002\u53c2\u8003\u6587\u732e1. Schoenfeld Adam J,Chan Joseph M,Kubota Daisuke et al. EGFRTumor Analyses Reveal Squamous Transformation and Off-Target Alterations As Early Resistance Mechanisms to First-line Osimertinib in -Mutant Lung Cancer.[J] .Clin Cancer Res, 2020, 26: 2654-2663. 2. Niederst Matthew J,Hu Haichuan,Mulvey Hillary E et al. The Allelic Context of the C797S Mutation Acquired upon Treatment with Third-Generation EGFR Inhibitors Impacts Sensitivity to Subsequent Treatment Strategies.[J] .Clin Cancer Res, 2015, 21: 3924-33. 3. Zhou Zhen,Zhao Yi,Shen Shengping et al. Durable Clinical Response of Lung Adenocarcinoma Harboring EGFR 19Del\/T790M\/in trans-C797S to Combination Therapy of First- and Third-Generation EGFR Tyrosine Kinase Inhibitors.[J] .J Thorac Oncol, 2019, 14: e157-e159. 4. Wang Yubo,Yang Nong,Zhang Yongchang et al. Effective Treatment of Lung Adenocarcinoma Harboring EGFR-Activating Mutation, T790M, and cis-C797S Triple Mutations by Brigatinib and Cetuximab Combination Therapy.[J] .J Thorac Oncol, 2020, 15: 1369-1375. 5. Sequist Lecia V,Han Ji-Youn,Ahn Myung-Ju et al. Osimertinib plus savolitinib in patients with EGFR mutation-positive, MET-amplified, non-small-cell lung cancer after progression on EGFR tyrosine kinase inhibitors: interim results from a multicentre, open-label, phase 1b study.[J] .Lancet Oncol, 2020, 21: 373-386. 6. Fassunke Jana,M\u00fcller Fabienne,Keul Marina et al. Overcoming EGFR-mediated osimertinib resistance through unique binding characteristics of second-generation EGFR inhibitors.[J] .Nat Commun, 2018, 9: 4655. 7. Starrett Jacqueline H,Guernet Alexis A,Cuomo Maria Emanuela et al. EGFRDrug Sensitivity and Allele Specificity of First-Line Osimertinib Resistance Mutations.[J] .Cancer Res, 2020, 80: 2017-2030. 8. 2021 ASCO\u4f1a\u8bae 9. Huang Yihua,Gan Jiadi,Guo Kunbin et al. Acquired BRAF V600E Mutation Mediated Resistance to Osimertinib and Responded to Osimertinib, Dabrafenib, and Trametinib Combination Therapy.[J] .J Thorac Oncol, 2019, 14: e236-e237. 10. Fukuda Koji,Otani Sakiko,Takeuchi Shinji et al. Trametinib overcomes KRAS-G12V-induced osimertinib resistance in a leptomeningeal carcinomatosis model of EGFR-mutant lung cancer.[J] .Cancer Sci, 2021, undefined: undefined. 11. La Monica Silvia,Cretella Daniele,Bonelli Mara et al. Trastuzumab emtansine delays and overcomes resistance to the third-generation EGFR-TKI osimertinib in NSCLC EGFR mutated cell lines.[J] .J Exp Clin Cancer Res, 2017, 36: 174. 12. Tang Zheng-Hai,Lu Jin-Jian,Osimertinib resistance in non-small cell lung cancer: Mechanisms and therapeutic strategies.[J] .Cancer Lett, 2018, 420: 242-246. \u5b89\u9f99\u57fa\u56e0\u5b89\u9f99\u57fa\u56e0\u79d1\u6280\u6709\u9650\u516c\u53f8\uff08\u7b80\u79f0\u5b89\u9f99\u57fa\u56e0\uff09\u6210\u7acb\u4e8e2016\u5e749\u67081\u65e5\uff0c\u521b\u59cb\u56e2\u961f\u6210\u5458\u6765\u81ea\u6e05\u534e\u5927\u5b66\u533b\u5b66\u9662\uff0c\u662f\u4e00\u5bb6\u540c\u65f6\u62e5\u6709\u7b2c\u4e09\u65b9\u68c0\u6d4b\u670d\u52a1\u548cIVD\u8bd5\u5242\u53ca\u4eea\u5668\u7814\u53d1\u3001\u751f\u4ea7\u3001\u6ce8\u518c\u548c\u9500\u552e\u4e3a\u4e00\u4f53\u7684\u56fd\u5bb6\u9ad8\u65b0\u6280\u672f\u4f01\u4e1a\u3002 \u516c\u53f8\u7814\u53d1\u7684\u6280\u672f\u6ce8\u91cd\u4e34\u5e8a\u5e94\u7528\u4fbf\u5229\u6027\uff0c\u5177\u6709\u66f4\u7b80\u4fbf\u7684\u64cd\u4f5c\u548c\u66f4\u5feb\u901f\u7684\u6d41\u7a0b\u3002\u76ee\u524d\u5df2\u5f00\u53d1\u4e86\u5305\u62ecOmegaSeq\u6269\u589e\u5b50\u6355\u83b7\u5efa\u5e93\u6280\u672f\u3001\u591a\u91cd\u5f15\u7269\/\u63a2\u9488\u53cc\u963b\u65adctDNA\u7532\u57fa\u5316\u68c0\u6d4b\u6280\u672f\u4ee5\u53ca\u81ea\u52a8\u5316\u6570\u636e\u5206\u6790\u6280\u672f\u7b49\u591a\u9879\u80bf\u7624\u7cbe\u51c6\u533b\u7597\u4f34\u968f\u8bca\u65ad\/\u8f85\u52a9\u8bca\u7597\u6280\u672f\uff0c\u5df2\u5efa\u7acb10\u4e07\u4f59\u4f8b\u8fd130\u79cd\u764c\u75c7\u57fa\u56e0\u6570\u636e\u5e93\uff0c\u5f62\u6210\u4e86\u4f01\u4e1a\u5728\u884c\u4e1a\u5185\u7684\u6280\u672f\u58c1\u5792\u3002 \u6b64\u5916\uff0c\u8fd8\u642d\u5efa\u4e86\u5305\u62ecPCR\u3001\u6570\u5b57PCR\u3001\u4e00\u4ee3\u6d4b\u5e8f\u3001\u4e8c\u4ee3\u6d4b\u5e8f\u7b49\u5728\u5185\u7684\u591a\u79cd\u68c0\u6d4b\u5e73\u53f0\uff0c\u7b2c\u4e09\u65b9\u68c0\u6d4b\u670d\u52a1\u4ea7\u54c1\u8986\u76d6\u4e86\u7cbe\u51c6\u514d\u75ab\u6cbb\u7597\u3001\u80bf\u7624\u7cbe\u51c6\u7528\u836f\u6307\u5bfc\u3001\u80bf\u7624\u65e9\u671f\u7b5b\u67e5\u3001\u80bf\u7624\u9057\u4f20\u6027\u7b5b\u67e5\u53ca\u9884\u540e\u9884\u6d4b\u7b49\u5168\u5468\u671f\u670d\u52a1\uff0c\u63d0\u4f9b\u80bf\u7624\u7cbe\u51c6\u8bca\u7597\u6574\u4f53\u89e3\u51b3\u65b9\u6848\u3002\u516c\u53f8\u62e5\u6709\u591a\u4e2a\u56fd\u5185\u9996\u521b\u764c\u75c7\u65e9\u7b5b\u4ea7\u54c1\uff0c\u5e76\u9488\u5bf9\u4e34\u5e8a\u5f00\u53d1\u4e86\u62e5\u6709\u81ea\u4e3b\u77e5\u8bc6\u4ea7\u6743\u3001\u56fd\u5185\u9996\u521b\u7684\u5168\u81ea\u52a8\u6838\u9178\u63d0\u53d6\u786b\u5316\u4eea\u3002 \u76ee\u524d\u5b89\u9f99\u57fa\u56e0\u5df2\u7533\u8bf730\u4f59\u9879\u77e5\u8bc6\u4ea7\u6743\uff0c\u4ee5\u6ee1\u5206\u6210\u7ee9\u901a\u8fc7\u591a\u9879\u5168\u56fd\u4e34\u5e8a\u68c0\u9a8c\u5ba4\u95f4\u8d28\u91cf\u8bc4\u4ef7\uff0c\u5e76\u83b7\u5f97\u201c\u56fd\u5bb6\u9ad8\u65b0\u6280\u672f\u4f01\u4e1a\u201d\u3001\u201c\u5b89\u5fbd\u7701\u6218\u7565\u65b0\u5174\u4ea7\u4e1a\u96c6\u805a\u53d1\u5c55\u57fa\u5730\u201d\u3001\u201c\u5b89\u5fbd\u7701\u9ad8\u5c42\u6b21\u79d1\u6280\u4eba\u624d\u56e2\u961f\u201d\u3001\u201c\u4e2d\u56fd\u9690\u5f62\u72ec\u89d2\u517d500\u5f3a\u201d\u7b49\u591a\u9879\u8363\u8a89\u79f0\u53f7\u3002\u5b89\u9f99\u57fa\u56e0\u5b89\u9f99\u533b\u5b66\u6211\u77e5\u9053\u4f60\u5728\u770b\u54df","source_url":"https:\/\/www.anlongen.com\/Article\/detail\/id\/172.html","alternate_url":"https:\/\/www.anlongen.com\/Article\/aiFeed\/id\/172.html","updated_at":"2024-05-20T00:00:00+08:00"}}