Механизмы приобретенной резистентности к анти-EGFR-препаратам при немелкоклеточном раке легкого, не связанной с мутацией Т790М, и их значение в клинической практике

Перспективы лечебных стратегий пациентов с немелкоклеточным раком легкого (НМРЛ) и наличием приобретенной резистентности к ингибиторам тирозинкиназы, не связанной с мутацией Т790М, с научных позиций достаточно широки, но в рутинной клинической практике в полном объеме пока недоступны. Понимание механизмов приобретенной резистентности к ингибиторам тирозинкиназы важно для клиницистов с позиции возможностей формирования более эффективных опций 2-й и последующих линий терапии НМРЛ. Наиболее изученным и частым механизмом, обусловливающим формирование приобретенной резистентности, является возникновение мутации Т790М в экзоне 20 гена EGFR. В данной статье представлены современные представления о механизмах приобретенной резистентности к ингибиторам тирозинкиназы, не связанной с мутацией Т790М, кратко изложена эволюция взглядов на лечение НМРЛ, прогрессирующего на фоне применения препаратов этой группы. Принимая во внимание многогранность нерешенных вопросов и направлений дальнейших научных поисков, нельзя забывать об имеющихся результатах исследований и умении грамотного использования описанных опций в рутинной клинической практике.

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