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  • Title: [Precision medical treatment of non-adenocarcinoma NSCLC patients with EGFR mutation].
    Author: Wang ZH, Song XY.
    Journal: Zhonghua Zhong Liu Za Zhi; 2017 Feb 23; 39(2):90-93. PubMed ID: 28219201.
    Abstract:
    EGFR tyrosine kinase inhibitors (TKIs) treatment has been established as standard therapy for EGFR-mutated adenocarcinomas. In the studies which published prospective randomized trials comparing EGFR TKIs with chemotherapy, a very low percentage of EGFR-mutated non-adenocarcinomas was enrolled in clinical trials. The efficacy of TKIs treatment for EGFR-mutated non-adenocarcinomas and their relationship with clinicopathological characteristics remain debatable. The results of retrospective studies show that the frequency of EGFR mutation is lower in non-adenocarcinoma than that of adenocarcinoma and efficacy of TKIs treatment for non-adenocarcinoma is inferior to adenocarcinoma. Smoking status is significantly associated with the efficacy of TKIs treatment for EGFR-mutated non-adenocarcinomas. The EGFR mutation rate and efficacy of TKIs treatment in adenosquamous cell carcinoma are higher than those of squamous cell carcinoma or large cell lung carcinoma. It may be concluded that the incidence of EGFR mutations in patients with non-adenocarcinoma NSCLC from mainland China is not very low and it is reasonable that EGFR TKIs could be an option for the treatment of EGFR-mutated non-adenocarcinoma NSCLC, especially for patients with adenosquamous histology and non-smokers. It is necessary to conduct a large-sample prospective study to understand the clinicopathological characteristics of non-adenocarcinomas and to evaluate the efficacy of EGFR TKI treatment or/and chemotherapy for EGFR-mutated non-adenocarcinoma NSCLC. 酪氨酸激酶抑制剂(TKIs)是表皮生长因子受体(EGFR)突变肺腺癌的标准治疗。在既往有关TKIs的前瞻性随机对照临床研究中，EGFR突变的非腺癌非小细胞肺癌(NSCLC)的例数较少，其临床病理学特征以及与TKIs治疗相关性的研究不够充分。回顾性研究结果显示，非腺癌NSCLC的EGFR突变率低于腺癌，且TKIs的疗效也低于EGFR突变的肺腺癌，吸烟状态是预测EGFR突变非腺癌NSCLC患者TKIs疗效的主要因素。肺腺鳞癌的EGFR突变率和TKIs疗效优于EGFR突变的鳞癌或大细胞癌。在中国大陆人群中，非腺癌NSCLC的EGFR突变率并非很低，EGFR－TKIs作为EGFR突变非腺癌尤其腺鳞癌和非吸烟患者的一个重要治疗选择是合理的。有必要进行较大样本的前瞻性临床研究，以确定EGFR突变的非腺癌NSCLC的临床病理学特征以及TKIs和细胞毒化疗的相关疗效。.
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