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摘要: 分子靶向治疗是近年来恶性肿瘤治疗领域的重点研究方向之一。随着EGFR-TKI靶向药物的出现与临床应用,棘皮动物微管相关类蛋白4-间变性淋巴瘤激酶融合基因(EML4-ALK)相关信号通路,以及针对此信号通路的靶向药物研究成为非小细胞肺癌研究的热点。在ALK 阳性的非小细胞肺癌中,EML4-ALK 信号通路靶向药物克唑替尼取得了良好的疗效。除EML4-ALK信号通路外,克唑替尼作用机制可能涉及到其他多个信号通路。本文报道1例克唑替尼治疗晚期ALK阴性的非小细胞肺癌短期内取得明显疗效,但该患者最终死于多种并发症。现对该病例进行报告并进行文献复习。
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[1] [中华人民共和国卫生部. 《2008年中国卫生统计》年鉴. 第1版. 北京: 中国协和医科大学出版社, 2008, 214-215.Ministy of Health of The People's Republic of China. 《China Health Statis- tics 2008》Yearbook. 1st ed. Beijing: Chinese Peking Union Medical Col- lege Press, 2008, 214-215. [2] 段建春, 王洁. ALK阳性非小细胞肺癌克唑替尼的耐药机制及应对策略[J].《中国临床肿瘤学进展2013》人民卫生出版社,2013.47-49. [3] Soda M, Choi YL, Enomoto M, et al. Identification of the transform- ing EML4-ALK fusion gene in non-small cell lung cancer[J]. Nature, 2007, 448(7153): 561-566. doi: 10.1038/nature05945 [4] Shaw AT, Ou SH;Bang YJ, et al. Crizotinib in ROS1-Rearranged Non-Small-Cell Lung Cancer[J]. N Engl J Med. 2014, Sep 27. [5] Huqun, Izumi S, Miyazawa H, et al. Mutations in the SLC34A2 gene are associated with pulmonary alveolar microlithiasis[J]. Am J Respir Crit Care Med, 2007, 175(3): 263-8. doi: 10.1164/rccm.200609-1274OC [6] Bergethon K, Shaw AT, Ou SH, et al. ROS1 rearrangements define a unique molecular class of lung cancers[J]. J Clin Oncol, 2012, 30 (8): 863-70. doi: 10.1200/JCO.2011.35.6345 [7] Ou SH, Kwak EL, Siwak-Tapp C, et al. Activity of crizotinib (PF02341066), a dual mesenchymal-epithelial transition (MET) and anaplastic lymphoma kinase (ALK) inhibitor, in a non-small cell lung cancer patient with de novo MET amplification[J]. J Thorac Oncol, 2011, 6(5): 942-6. doi: 10.1097/JTO.0b013e31821528d3 [8] Oxnard GR, Binder A, Jänne PA. New targetable oncogenes in non-small- cell lung cancer[J]. J Clin Oncol, 2013, 31(8): 1097-104. doi: 10.1200/JCO.2012.42.9829 [9] Shaw AT, Kim DW,Nakagawa K, et al. Crizotinib versus chemotherapy in advanced ALK-positive lung cancer[J]. N Engl J Med, 2013, 368(25): 2385-94. doi: 10.1056/NEJMoa1214886 [10] Pfizer, Inc. Xalkori prescribing information [OL].http://www. accessdata.fda.gov/drugsatfda_docs/label/201 1/202570s000lbl. [11] Vaishnavi A, Capelletti M, Le AT, et al. Oncogenic and drug-sensitive NTRK1 rearrangements in lung cancer[J]. Nat Med, 2013, 19(11): 1469-72. doi: 10.1038/nm.3352 [12] 颜才华, 李晓阳, 马一杰, 等. 晚期非小细胞肺癌个体化治疗研究进展 [J]. 中华临床医师杂志,2014, 8(4): 721-5.
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