EGFR突变NSCLC二线TKIs治疗优化选择

恶性肿瘤的治疗已经进入驱动基因指导下的个体治疗时代，肺癌患者应该进行多基因检测，特别是表皮生长因子受体（EGFR）基因突变。EGFR基因突变的非小细胞肺癌（NSCLC）患者，如果一线接受了化疗，二线应该选择表皮生长因子受体一酪氨酸酶抑制剂（EGFR—TKIs）。EGFR基因突变的NSCLC患者一线EGFR—TKIs治疗失败后，二线治疗应该是个体化合理选择，包括局部放疗、化疗和继续EGFR—TKIs。目前一代和二代EGFR—TKIs药物之间未见到显著疗效差别。第三代EGFR—TKIs是目前的EGFR—TKIs耐药后的最有希望的选择，特别是针对T790M突变耐药。

How to Choose in 2nd Line Treatment in NSCLC Patients with EGFR Gene Mutation

The treatment of metastatic NSLCL has entered into individual era based on biomakers tests, especially EGFR gene mutation. In patients with EGFR gene mutation, who received chemotherapy as the first line treatment, the best choice for the 2nd line treatment should be EGFR-TKIs. In patients with EGFR gene mutation, who received EGFR-TKIs as the first line treatment, the best choice for the 2nd line treatment should be individual, mostly based on the progress model, including local radiotherapy, chemotherapy or continue EGFR-TKIs. There is no difference among all 1ST and 2nd generation EGFR-TKIs. 3rd generation EGFR-TKIs, are the most hopeful choices for patients failed to EGFR-TKIs, especially for patients with T790M mutation.