奥希替尼耐药机制与治疗策略综述

类型: 论文 发表日期: 2022-12-08 入库日期: 2026-05-21 来源: Journal of Hematology & Oncology 标签: EGFR L858R, 奥希替尼耐药, C797S, MET扩增, SCLC转化, 再活检

Citation

Fu K, Xie F, Wang F, Fu L. Therapeutic strategies for EGFR-mutated non-small cell lung cancer patients with osimertinib resistance. Journal of Hematology & Oncology. 2022. DOI: 10.1186/s13045-022-01391-4

Why this is in CCL

This open-access review is a map of what to look for when EGFR-mutated NSCLC progresses on osimertinib: on-target EGFR changes, bypass pathways, fusions, downstream alterations, and histologic transformation.

Key takeaways

• Osimertinib resistance is heterogeneous; one treatment plan cannot be inferred without new molecular/pathology data.
• Repeat tissue biopsy is especially important when imaging or markers suggest transformation.
• Resistance categories include EGFR C797S, MET amplification, HER2 amplification, downstream pathway changes, fusions, EMT, squamous transformation, and SCLC transformation.

Practical relevance

• Supports the family’s existing question list: repeat biopsy, new NGS, MET amplification, C797S/T790M, and neuroendocrine markers.
• The consult agent should use this as a resistance-mechanism checklist, not as a treatment prescription.