2016年7月15日最近临床试验证实，第三代表皮生长因子受体(epidermal growth factor receptor, EGFR)酪氨酸激酶抑制剂 (tyrosine kinase inhibitor, TKI) osimertinib(Tagrisso)可作为EGFR突变T790M阳性的非小细胞肺癌(NSCLC)的一线用药。研究结果在日内瓦举办2016欧肺癌大会上公布(the European Lung Cancer Conference (ELCC) 2016)。

EGFR抑制剂是治疗EGFR突变的非小细胞肺癌肺癌的标准方案，但是有50-60%的患者会在治疗中产生T790M突变而导致抗药性产生。Osimertinib是原发EGFR突变 (exon 19 and exon 21)和T790M突变的强力抑制剂。

会议上还公布了另一项临床试验结果：对经过EGFR TKI抑制剂治疗失败的EGFR突变T790M阳性的NSCLC患者，可使用osimertinib (80mg每天) 获得70%左右的治疗反应。

Key Points

◆ Usingosimertinib as first-line therapy for EGFR-mutated NSCLCresulted in an overall response rate of 77%. Median progression-free survival was 19.3 months for the 160-mg doseand has not yet been reached for the 80-mg dose. Median duration of response has not been reached.

◆ The mature results of two studies that investigated osimertinib at the recommended80-mg dose in EGFR-mutated and T790M-positive NSCLCpatients who had disease progression on previous EGFR tyrosine kinase inhibitor therapy found that response rates were 71% in the phase I dose-expansion cohort of 63 patients and 66% in pooled results from two phase II studies of 411 patients. Progression-free survival was 9.7 and 11 months for the phase I cohort and phase II studies, respectively.

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