{"id":727,"date":"2023-12-20T21:59:41","date_gmt":"2023-12-20T13:59:41","guid":{"rendered":"http:\/\/www.yaozhiyou.com\/?p=727"},"modified":"2023-12-20T21:59:41","modified_gmt":"2023-12-20T13:59:41","slug":"%e4%b8%89%e4%bb%a3-alk-tki-%e5%8a%b3%e6%8b%89%e6%9b%bf%e5%b0%bc%e8%b7%bb%e8%ba%ab%e5%9b%bd%e5%ae%b6%e5%8c%bb%e4%bf%9d%ef%bc%8calk-%e9%9d%b6%e5%90%91%e8%8d%af%e7%89%a9%e5%a6%82%e4%bd%95%e9%80%89","status":"publish","type":"post","link":"http:\/\/www.yaozhiyou.com\/?p=727","title":{"rendered":"\u4e09\u4ee3 ALK-TKI \u52b3\u62c9\u66ff\u5c3c\u8dfb\u8eab\u56fd\u5bb6\u533b\u4fdd\uff0cALK \u9776\u5411\u836f\u7269\u5982\u4f55\u9009\u62e9\uff1f"},"content":{"rendered":"

\"\u4e09\u4ee3<\/p>\n

2023 \u5e74 3 \u6708 1 \u65e5\uff0c2022 \u7248\u56fd\u5bb6\u533b\u4fdd\u76ee\u5f55\u6b63\u5f0f\u5f00\u59cb\u5b9e\u65bd\uff0c\u4eca\u5e74\u66f4\u65b0\u7684\u533b\u4fdd\u8c08\u5224\u836f\u54c1\u4e2d\u7684\u6d1b\u62c9\u66ff\u5c3c\u662f\u80ba\u764c\u91cd\u78c5\u836f\u7269\u4e4b\u4e00\u3002\u6d1b\u62c9\u66ff\u5c3c\u5728\u6211\u56fd\u4e0a\u5e02\u4e4b\u524d\u6211\u4eec\u5c06\u5176\u79f0\u4e3a\u52b3\u62c9\u66ff\u5c3c<\/i><\/a>\uff0c\u5176\u4e3a\u4e09\u4ee3 ALK \u9776\u5411\u4ee3\u8868\u836f\u7269\u3002<\/strong><\/section>\n
<\/section>\n
\u4e09\u4ee3 EGFR \u4ee3\u8868\u7684\u9776\u5411\u836f\u7269\u5965\u5e0c\u66ff\u5c3c\u51fa\u8272\u8868\u73b0\uff0c\u4e09\u4ee3 ALK \u9776\u5411\u836f\u7269\u4ee3\u8868\u6d1b\u62c9\u66ff\u5c3c\u5728\u6211\u56fd\u4e0a\u5e02\u4e4b\u524d\u5c31\u88ab\u56fd\u5185\u80bf\u7624\u754c\u7ed9\u4e88\u539a\u671b\u3002\u6d1b\u62c9\u66ff\u5c3c\u76f4\u5230 2022 \u5e74 4 \u6708\u5e95\u624d\u6b63\u5f0f\u83b7 NMPA \u6279\u51c6\u5728\u56fd\u5185\u4e0a\u5e02<\/strong>\uff0c\u4e0d\u8fc7\u8fd9\u4e2a\u65f6\u95f4\u70b9\u4e5f\u5361\u5728\u53bb\u5e74\u533b\u4fdd\u8c08\u5224\u62a5\u540d\u65e5\u671f\u4e4b\u524d\uff0c\u8bf4\u660e\u6d1b\u62c9\u66ff\u5c3c\u4e5f\u662f\u5954\u7740\u4eca\u5e74\u533b\u4fdd\u8c08\u5224\u800c\u53bb\u7684\u3002\u679c\u4e0d\u5176\u7136\uff0c\u6d1b\u62c9\u66ff\u5c3c\u786e\u5b9e\u987a\u5229\u8fdb\u5165\u4eca\u5e74\u533b\u4fdd\u8c08\u5224\u76ee\u5f55\u3002<\/section>\n
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\u8fd9\u6837\u6211\u4eec\u56fd\u5bb6\u533b\u4fdd\u76ee\u5f55\u4e2d ALK \u9776\u5411\u836f\u7269\u7684\u4e00\u4ee3\u3001\u4e8c\u4ee3\u3001\u4e09\u4ee3\u90fd\u5df2\u96c6\u9f50\uff0c\u963f\u6765\u66ff\u5c3c\uff08\u4e8c\u4ee3\u76ee\uff09\u548c\u6d1b\u62c9\u66ff\u5c3c\uff08\u4e09\u4ee3\u76ee\uff09\u5728\u548c\u514b\u5511\u66ff\u5c3c\uff08\u4e00\u4ee3\u76ee\uff09\u7684\u5934\u5bf9\u5934\u6bd4\u8f83\u7814\u7a76\u4e2d\u90fd\u53d6\u5f97\u5b8c\u80dc<\/strong>\uff0c\u8fd9\u6837\u4e00\u6765\u963f\u6765\u66ff\u5c3c\u548c\u6d1b\u62c9\u66ff\u5c3c\u90fd\u83b7\u5f97\u00a0NCCN<\/i><\/a>\u00a0\u9996\u9009\u63a8\u8350\u5730\u4f4d\uff08Preferred\uff09, \u4f5c\u4e3a\u4e00\u4ee3\u7684\u514b\u5511\u66ff\u5c3c\u53ef\u4ee5\u8bf4\u5df2\u7ecf\u88ab\u540e\u6765\u8005\u62cd\u5728\u4e86\u6c99\u6ee9\u4e0a\uff0c\u56e0\u6b64 ALK \u878d\u5408\u7684\u665a\u671f NSCLC \u9996\u9009\u4e8c\u4ee3\u3001\u4e09\u4ee3\u662f\u6ca1\u6709\u4e89\u8bae\u7684\u3002<\/section>\n
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\u4f46\u9996\u9009\u963f\u6765\u66ff\u5c3c\u8fd8\u662f\u6d1b\u62c9\u66ff\u5c3c\u73b0\u5728\u4f9d\u7136\u6ca1\u6709\u7edf\u4e00\u7684\u610f\u89c1\uff0c\u90a3\u4e48\u4f5c\u4e3a ALK \u4e09\u4ee3\u76ee\u7684\u6d1b\u62c9\u66ff\u5c3c\u5728\u54ea\u4e9b\u65b9\u9762\u6709\u4f18\u52bf\uff0c\u54ea\u4e9b\u4eba\u7fa4\u5efa\u8bae\u9009\u62e9\u5462\uff1f\u4e0b\u9762\u6211\u4eec\u7ed3\u5408\u5faa\u8bc1\u533b\u5b66\u8bc1\u636e\u63a2\u8ba8\u4e00\u4e0b\u3002<\/section>\n
<\/section>\n
\u6d1b\u62c9\u66ff\u5c3c\u4e3a\u4ec0\u4e48\u662f\u4e09\u4ee3 ALK-TKI?<\/strong><\/section>\n
<\/section>\n
ALK-TKI \u5747\u4e3a\u4e09\u78f7\u9178\u817a\u82f7<\/i><\/a>\uff08ATP\uff09\u7ade\u4e89\u6027\u6291\u5236\u5242\uff0c\u5176\u901a\u8fc7\u4e0e ALK \u878d\u5408\u86cb\u767d\u6fc0\u9176\u57df\u7684 ATP \u7ed3\u5408\u53e3\u888b\u7ade\u4e89\u6027\u7ed3\u5408\uff0c\u6291\u5236 ALK \u6d3b\u6027\uff0c\u963b\u65ad\u4e0b\u6e38\u4fe1\u53f7\u901a\u8def\u7684\u6fc0\u6d3b\uff0c\u4ece\u800c\u53d1\u6325\u6297\u80bf\u7624\u4f5c\u7528\u3002<\/section>\n
<\/section>\n
\u4e00\u4ee3\u7684 TKI \u514b\u5511\u66ff\u5c3c\u3001\u4e8c\u4ee3\u7684 TKI \u963f\u6765\u66ff\u5c3c\u3001\u585e\u745e\u66ff\u5c3c\u7b49\u836f\u7269\uff0c\u5747\u4e3a\u65e0\u73af\u7c7b\u3001\u957f\u94fe\u72b6\u5316\u5408\u7269\uff0c\u800c\u4e09\u4ee3\u7684\u6d1b\u62c9\u66ff\u5c3c\u57fa\u4e8e\u4e00\u4ee3\u3001\u4e8c\u4ee3 TKI \u7684\u95ee\u9898\u8fdb\u884c\u4f18\u5316\uff0c\u91c7\u7528\u4e86\u5b8c\u5168\u4e0d\u540c\u7684\u5c0f\u5206\u5b50\u5927\u73af\u9170\u80fa\u7ed3\u6784\uff0c\u6b64\u79cd\u7ed3\u6784\u6709\u4ee5\u4e0b\u4f18\u52bf<\/strong>\uff1a<\/section>\n
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1\u3001\u4e0e\u65e0\u73af\u7c7b\u5316\u5408\u7269\u76f8\u6bd4\uff0c\u5927\u73af\u7ed3\u6784\u66f4\u7d27\u51d1\uff0c\u589e\u52a0\u4e86\u57cb\u85cf\u9762\u79ef\uff0c\u51e0\u4e4e\u53ef\u4ee5\u5b8c\u5168\u8fdb\u5165 ATP \u7ed3\u5408\u4f4d\u70b9\u7684\u53e3\u888b\u4e2d\u5fc3\uff0c\u4e0e\u6fc0\u9176\u57df\u7684\u76f8\u4e92\u7ed3\u5408\u4f5c\u7528\u529b\u66f4\u5f3a\u3001\u7ed3\u5408\u4e5f\u66f4\u52a0\u7a33\u56fa\uff0c\u6709\u5229\u4e8e\u63d0\u9ad8\u6297\u8010\u836f\u80fd\u529b\u3002<\/p>\n

2\u3001\u836f\u7269\u5206\u5b50\u91cf\u66f4\u5c0f\uff0c\u5e76\u63d0\u9ad8\u4e86\u5206\u5b50\u4eb2\u8102\u6027\uff0c\u6709\u5229\u4e8e\u51cf\u5c11 P-\u7cd6\u86cb\u767d\uff08P-gp\uff09\u7684\u5916\u6392\u4f5c\u7528\uff0c\u589e\u5f3a\u7a7f\u8d8a\u8840\u8111\u5c4f\u969c\u7684\u80fd\u529b\uff0c\u4ece\u800c\u6709\u6548\u9488\u5bf9 ALK \u7a81\u53d8\u60a3\u8005\u7684\u8111\u8f6c\u79fb\u95ee\u9898\u3002<\/p>\n

3\u3001\u4e8c\u4ee3 TKI \u836f\u7269\u5206\u5b50\u91cf\u76f8\u5bf9\u8f83\u5927\uff0c\u56e0\u6b64\u66f4\u6613\u53d7\u5230\u6eb6\u5242\u524d\u533a\u57df\u7a81\u53d8\u7684\u5f71\u54cd\uff0c\u5982 G1202R \u7a81\u53d8\u5c31\u662f\u5bfc\u81f4\u4e8c\u4ee3 TKI \u8010\u836f\u7684\u6700\u4e3b\u8981\u7a81\u53d8\u4e4b\u4e00\uff0c\u5c0f\u5206\u5b50\u5927\u73af\u9170\u80fa\u7ed3\u6784\u53ef\u907f\u514d\u8fd9\u79cd\u60c5\u51b5\u53d1\u751f\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

\u6b64\u5916\u6d1b\u62c9\u66ff\u5c3c\u7684\u7ed3\u6784\u8fd8\u662f\u67d4\u6027\u53ef\u6298\u53e0\u7684\uff0c\u7ed3\u5408\u4f4d\u70b9\u4e5f\u66f4\u52a0\u5168\u9762\uff0c\u8fd9\u4e9b\u7279\u70b9\u90fd\u589e\u5f3a\u4e86\u6d1b\u62c9\u66ff\u5c3c\u7684\u6297\u80bf\u7624\u6d3b\u6027\u3002<\/section>\n
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\u6d1b\u62c9\u66ff\u5c3c\u7597\u6548\u5982\u4f55\uff1f<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n
<\/section>\n
\u6d1b\u62c9\u66ff\u5c3c\u7528\u4e8e\u4e00\u7ebf\u6211\u4eec\u770b\u4e00\u4e0b\u5176 CROWN \u7814\u7a76\uff0cCROWN \u7814\u7a76\u662f\u4e00\u9879\u56fd\u9645\u3001\u8fdb\u884c\u4e2d\u7684\u3001\u968f\u673a\u3001\u2162\u671f\u7814\u7a76\uff0c\u5bf9\u6bd4\u6d1b\u62c9\u66ff\u5c3c\u4e0e\u514b\u5511\u66ff\u5c3c\u4e00\u7ebf\u6cbb\u7597 ALK \u9633\u6027 NSCLC \u7684\u7ed3\u679c\u3002<\/section>\n
<\/section>\n
2022 \u5e74\u7f8e\u56fd\u764c\u75c7\u7814\u7a76\u534f\u4f1a\uff08AACR\uff09\u5927\u4f1a\u66f4\u65b0\u4e86 CROWN \u7814\u7a76\u968f\u8bbf 3 \u5e74\u7684\u6700\u65b0\u7ed3\u679c\uff0c\u610f\u5411\u6cbb\u7597\u4eba\u7fa4\uff08ITT\uff09\u4e2d\u6d1b\u62c9\u66ff\u5c3c\u7ec4\u548c\u514b\u5511\u66ff\u5c3c\u7ec4\u7684\u4e2d\u4f4d\u968f\u8bbf\u65f6\u95f4\u5206\u522b\u4e3a 36.7 \u4e2a\u6708\u548c 29.3 \u4e2a\u6708\u3002<\/section>\n
<\/section>\n
\u7531\u76f2\u6001\u72ec\u7acb\u5ba1\u8bc4\u4e2d\u5fc3\uff08BICR\uff09\u8bc4\u4f30\u7684\u6d1b\u62c9\u66ff\u5c3c\u7ec4\u4e2d\u4f4d PFS \u5c1a\u672a\u8fbe\u5230\uff08\u514b\u5511\u66ff\u5c3c\u7ec4\u4e3a 9.3 \u4e2a\u6708\uff09\uff0cHR \u4f4e\u81f3 0.27\uff0895%CI\uff1a0.184-0.388\uff09\uff0c\u4e3a ALK \u9633\u6027\u665a\u671f NSCLC \u60a3\u8005\u5e26\u6765\u663e\u8457\u7684\u65e0\u8fdb\u5c55\u751f\u5b58\u83b7\u76ca\u3002<\/section>\n
\n
\u6d1b\u62c9\u66ff\u5c3c\u7528\u4e8e ALK+NSCLC \u4e8c\u7ebf\u6cbb\u7597\uff0c\u6211\u4eec\u770b\u4e00\u9879\u6765\u81ea\u65e5\u672c\u7684\u56de\u987e\u6027\u3001\u591a\u4e2d\u5fc3\u3001\u89c2\u5bdf\u6027\u7814\u7a76\u3002\u8be5\u7814\u7a76\u4e3a\u4e00\u9879\u771f\u5b9e\u4e16\u754c\u7684\u89c2\u5bdf\u6027\u7814\u7a76\uff0c\u4e3b\u8981\u8bc4\u4f30\u5bf9\u4e00\u7ebf (1L) \u963f\u6765\u66ff\u5c3c\u540e ALK+NSCLC \u60a3\u8005\u7ed9\u4e88\u6d1b\u62c9\u66ff\u5c3c\u540e\u4e34\u5e8a\u7597\u6548\u3002<\/section>\n
<\/section>\n
\u7814\u7a76\u7ed3\u679c\u663e\u793a\uff1a1L \u963f\u6765\u66ff\u5c3c\uff0c2L \u6d1b\u62c9\u66ff\u5c3c\u7684 TTF \u4e3a 10.8 \u4e2a\u6708 (95% CI, 3.9-13.8 \u4e2a\u6708); 1L \u963f\u6765\u66ff\u5c3c,\u00a0\u22653L \u6d1b\u62c9\u66ff\u5c3c\u7684 TTF \u4e3a 11.5 \u4e2a\u6708 (95% CI, 2.9 \u4e2a\u6708\uff0c\u4e0d\u53ef\u8bc4\u4f30 [NE])\u3002<\/section>\n
<\/section>\n
\u6709\u8111\u8f6c\u79fb\u7684\u60a3\u8005\u4e2d\u4f4d TTF \u4e3a 11.5 \u4e2a\u6708 (95% CI, 3.9 \u6708-NE)\uff0c\u65e0\u8111\u8f6c\u79fb\u7684\u60a3\u8005\u4e2d\u4f4d TTF \u4e3a 9.9 \u4e2a\u6708 (95% CI, 4.3-13.8 \u6708)\u30021L \u963f\u6765\u66ff\u5c3c, 2L \u6d1b\u62c9\u66ff\u5c3c\u7684 ORR \u4e3a 44.0% (95% CI, 24.4%-65.1%); 1L \u963f\u6765\u66ff\u5c3c, \u22653L \u6d1b\u62c9\u66ff\u5c3c\u7684 ORR \u4e3a 23.5% (95% CI, 6.8%-49.9%)\u3002<\/section>\n
<\/section>\n
\u7814\u7a76\u7ed3\u8bba\uff1a\u5728\u6ca1\u6709\u9057\u4f20\u8010\u836f\u673a\u5236\u4fe1\u606f\u7684\u60a3\u8005\u4e2d\uff0c\u5728\u963f\u6765\u66ff\u5c3c\u4e4b\u540e\u518d\u63a5\u53d7\u6d1b\u62c9\u66ff\u5c3c\u6cbb\u7597\u7684 TTF \u8d85\u8fc7 10 \u4e2a\u6708\u3002<\/strong><\/section>\n
\n
\u6765\u81ea\u4e0e\u6211\u56fd\u53f0\u6e7e ALK \u9633\u6027\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\u60a3\u8005\u7684\u771f\u5b9e\u7814\u7a76\u8bc1\u636e\u53d1\u73b0\uff0c\u6d1b\u62c9\u66ff\u5c3c\u4f5c\u4e3a\u4e8c\u7ebf\u53ca\u4ee5\u4e0a\u7684 ALK \u9633\u6027\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\u7684\u4e2d\u4f4d\u603b PFS 9.5 \u4e2a\u6708<\/strong>\uff0c\u6d1b\u62c9\u66ff\u5c3c\u4f5c\u4e3a\u7b2c 2 \u4e2a TKI \u7684\u60a3\u8005\u4e2d\u4f4d PFS \u4e0d\u6210\u719f\u3002<\/section>\n
<\/section>\n
\u6d1b\u62c9\u66ff\u5c3c\u4f5c\u4e3a\u7b2c 3 \u4e2a ALK TKI \u53ca\u540e\u7ebf ALK TKI \u65f6\uff0c\u4e2d\u4f4d PFS \u5206\u522b\u4e3a 14.6 \u4e2a\u6708\u548c 9.5 \u4e2a\u6708\u3002\u5bf9\u4e8e\u6709\u8111\u8f6c\u79fb\u57fa\u7ebf\u7684\u60a3\u8005\uff0c\u4e2d\u4f4d PFS \u4e3a 15.4 \u4e2a\u6708\u3002<\/strong><\/section>\n
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\u6d1b\u62c9\u66ff\u5c3c VS. \u963f\u6765\u66ff\u5c3c \u767e\u5bb6\u4e89\u9e23<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n
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\u867d\u8bf4 CROWN \u7814\u7a76\u5c1a\u672a\u5b8c\u7ed3\uff0c\u6d1b\u62c9\u66ff\u5c3c\u7684\u4e2d\u4f4d PFS \u5c1a\u672a\u8fbe\u5230\uff0c\u4f46\u73b0\u6709\u7684\u7814\u7a76\u7ed3\u679c\u5df2\u7ecf\u80fd\u786e\u5b9a\uff1a\u6d1b\u62c9\u66ff\u5c3c\u7528\u4e8e ALK \u878d\u5408\u665a\u671f NSCLC \u5927\u5e45\u663e\u8457\u4f18\u4e8e\u514b\u5511\u66ff\u5c3c\uff0c\u4f46\u5bf9\u4e8e\u6d1b\u62c9\u66ff\u5c3c\u7528\u4e8e\u4e00\u7ebf\uff0c\u4e00\u4e9b\u5b66\u8005\u5bf9\u6b64\u6709\u5f02\u8bae\uff0c\u5f62\u6210\u4e86\u6b63\u53cd\u4e24\u6d3e\u3002<\/section>\n
\u00a0<\/strong><\/section>\n
\u00a0<\/strong><\/section>\n
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\u6b63\u65b9\uff1a\u652f\u6301\u6d1b\u62c9\u66ff\u5c3c\u4f5c\u4e3a\u4e00\u7ebf\u9996\u9009 ALK \u6291\u5236\u5242<\/strong><\/section>\n
\n
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<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n
<\/section>\n
\u539f\u56e0\uff1a<\/strong>\u6d1b\u62c9\u66ff\u5c3c\u5728 CROWN \u7814\u7a76\u4e2d\u76f8\u6bd4\u5176\u4ed6 ALK \u6291\u5236\u5242\u5177\u6709 HR\u3001PFS \u4f18\u52bf\uff0c\u56e0\u800c\u5176\u7597\u6548\u5360\u4f18\uff0c\u63a8\u8350\u4e00\u7ebf\u4f7f\u7528\u3002<\/section>\n
<\/section>\n
1\u3001HR \u4f18\u52bf\uff1a<\/strong><\/section>\n
<\/section>\n
\u5355\u72ec\u5206\u6790 CROWN \u7814\u7a76\u6570\u636e\uff0c\u4e0e\u514b\u5511\u66ff\u5c3c\u76f8\u6bd4\uff0c\u6d1b\u62c9\u66ff\u5c3c\u5177\u6709 \u300cbest-in-class\u300d \u7684\u65e0\u8fdb\u5c55\u751f\u5b58\u671f\uff08PFS\uff09\u83b7\u76ca\u4f18\u52bf\uff08\u98ce\u9669\u6bd4 [HR]= 0.24\uff0c95%\u00a0\u53ef\u4fe1\u533a\u95f4<\/i><\/a>\u00a0[CI]\uff1a0.14\uff5e0.41\uff09\u3002<\/section>\n
<\/section>\n
\u76f8\u6bd4\u4e4b\u4e0b\uff0c\u5c06\u5176\u4ed6\u4e0b\u4e00\u4ee3 ALK \u6291\u5236\u5242\u963f\u6765\u66ff\u5c3c\u3001\u5e03\u52a0\u66ff\u5c3c\u548c\u6069\u6c99\u66ff\u5c3c<\/i><\/a>\u4e0e\u514b\u5511\u66ff\u5c3c\u8fdb\u884c\u5bf9\u6bd4\u8bd5\u9a8c\uff0c\u4ea7\u751f\u7684 PFS HRs \u8f83\u4e3a\u76f8\u4f3c\uff0c\u8303\u56f4\u4e3a 0.51-0.37\u3002<\/section>\n
<\/section>\n
2\u3001PFS \u4f18\u52bf\uff1a<\/strong><\/section>\n
\u00a0<\/strong><\/section>\n
<\/section>\n
\u5047\u8bbe\u4e00\u4e2a\u968f\u65f6\u95f4\u63a8\u79fb\u7684\u6052\u5b9a\u6bd4\u4f8b\u98ce\u9669\u6a21\u578b\uff0c\u57fa\u4e8e BIRC \u8bc4\u4f30\u7ed3\u679c\u7c97\u7565\u8ba1\u7b97\u514b\u5511\u66ff\u5c3c\u7684\u4e2d\u4f4d PFS \u9884\u8ba1\u4e3a 9.3 \u4e2a\u6708\uff0cHR \u4e3a 0.28\uff0895% CI: 0.19-0.41\uff09\uff0c\u6d1b\u62c9\u66ff\u5c3c\u4e2d\u4f4d PFS \u9884\u4f30\u4e3a 33.2 \u4e2a\u6708\uff0895%CI: 22.7-48.9 \u4e2a\u6708\uff09\u3002\u540c\u6837\uff0c\u6839\u636e\u7814\u7a76\u8005\u8bc4\u4f30\u7ed3\u679c\uff0c\u514b\u5511\u66ff\u5c3c\u7684\u4e2d\u4f4d PFS \u9884\u8ba1\u4e3a 9.1 \u4e2a\u6708\uff0cHR \u4e3a 0.21\uff0895%CI\uff1a0.14-0.31\uff09\uff0c\u6d1b\u62c9\u66ff\u5c3c\u4e2d\u4f4d PFS \u9884\u4f30\u4e3a 43.3 \u4e2a\u6708\uff0895%CI: 29.4+65.0 \u4e2a\u6708\uff09<\/strong>\u3002\u5982\u679c\u5b9e\u73b0\u8fd9\u4e24\u4e2a\u9884\u6d4b\u6570\u5b57\uff0c\u5c06\u662f\u4efb\u4f55 ALK TKI \u5728\u4e00\u7ebf\u6cbb\u7597\u4e2d\u6700\u957f\u4e2d\u4f4d PFS\u3002<\/section>\n
<\/section>\n
3\u3001\u6d1b\u62c9\u66ff\u5c3c\u5404\u4e9a\u7ec4\u5168\u9762\u4f18\u52bf\uff1a<\/strong><\/section>\n
<\/section>\n
CROWN \u8bd5\u9a8c\u68ee\u6797\u56fe\u4e2d\u7684\u6240\u6709\u4e9a\u7ec4\u5206\u6790\u7ed3\u679c\u5747\u663e\u793a\u6d1b\u62c9\u66ff\u5c3c\u4f18\u4e8e\u514b\u5511\u66ff\u5c3c\uff0c\u7ed3\u679c\u5177\u6709\u7edf\u8ba1\u5b66\u610f\u4e49\u3002<\/section>\n
\u00a0<\/strong><\/section>\n
\u00a0<\/strong><\/section>\n
\n
\n
\n
\n
\n
\n
\u53cd\u65b9\uff1a\u53cd\u5bf9\u6d1b\u62c9\u66ff\u5c3c\u4f5c\u4e3a\u4e00\u7ebf\u9996\u9009 ALK \u6291\u5236\u5242<\/strong><\/section>\n
\n
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<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n
<\/section>\n
\u539f\u56e0\uff1a<\/strong>ALK+ NSCLC \u7684 PFS \u6709\u4e00\u5b9a\u7684\u5bbd\u5bb9\u5ea6\uff0c\u6d1b\u62c9\u66ff\u5c3c\u53ef\u4ee5\u8003\u8651\u4e8c\u7ebf\u4f7f\u7528\uff0c\u800c\u4e14\u6d1b\u62c9\u66ff\u5c3c\u4e0d\u826f\u53cd\u5e94\u8f83\u4e25\u91cd\uff0c\u8be5\u836f\u5728\u4e34\u5e8a\u4e0a\u672a\u663e\u8457\u6539\u5584\u60a3\u8005\u751f\u6d3b\u8d28\u91cf\u8bc4\u5206\u3002<\/section>\n
<\/section>\n
1\u3001ALK+ NSCLC \u7684\u5168\u7a0b\u7ba1\u7406\uff1a<\/strong><\/section>\n
<\/section>\n
\u8fd1\u671f\u7814\u7a76\u53d1\u73b0\uff0c100 \u591a\u540d\u4f7f\u7528\u963f\u6765\u66ff\u5c3c\u7684\u665a\u671f ALK \u9633\u6027\u60a3\u8005\u5206\u6790\u62a5\u544a\u5176\u4e2d\u4f4d\u603b\u751f\u5b58\u671f\u8fbe\u5230 86 \u4e2a\u6708\uff0c\u8fdc\u8fdc\u7684\u9ad8\u4e8e\u963f\u6765\u66ff\u5c3c\u7684 34.8 \u4e2a\u6708\uff08mPFS\uff09\u7684\u65f6\u95f4\u957f\u5ea6\u3002<\/section>\n
<\/section>\n
\u56e0\u6b64\uff0c\u5b9e\u9645\u4e0a\u51e0\u4e4e\u6240\u6709 ALK+\u80ba\u764c\u60a3\u8005\u6700\u7ec8\u5747\u4f1a\u63a5\u53d7\u540e\u7ebf\u6cbb\u7597\u3002\u800c\u76ee\u524d\u5e76\u6ca1\u6709\u5145\u8db3\u7684\u8bc1\u636e\u8868\u660e\u524d\u671f\u5e94\u7528\u6d1b\u62c9\u66ff\u5c3c\u7684\u6cbb\u7597\u6548\u679c\u4f18\u4e8e\u5176\u5728\u540e\u7ebf\u6cbb\u7597\u4e2d\u6240\u53d1\u6325\u7684\u4f5c\u7528\u3002<\/strong>\u4e5f\u5c31\u662f\u8bf4\uff0c\u4e0d\u540c\u4e00\u7ebf\u6cbb\u7597\u65b9\u6848\u5bf9\u5e94\u7684\u521d\u59cb PFS \u5dee\u5f02\u53ef\u4ee5\u901a\u8fc7\u6709\u6548\u7684\u540e\u7ebf\u6cbb\u7597\u7ba1\u7406\u8fdb\u884c\u8865\u507f\u3002<\/strong><\/section>\n
<\/section>\n
2\u3001\u6bd2\u6027\u95ee\u9898\uff1a<\/strong><\/section>\n
<\/section>\n
\u4ece ALK \u9776\u5411\u6cbb\u7597\u5e94\u7528\u4e8e\u4e34\u5e8a\u5f00\u59cb\uff0cALK+\u665a\u671f NSCLC \u7684\u6cbb\u7597\u7406\u5ff5\u5df2\u7ecf\u4ece\u300c\u4e0d\u60dc\u4e00\u5207\u4ee3\u4ef7\u6cbb\u7597\u764c\u75c7\u300d\u8f6c\u53d8\u4e3a\u8ffd\u6c42\u300c\u5b8c\u7f8e\u63a7\u5236\u75be\u75c5\u5e76\u5408\u7406\u4fdd\u8bc1\u60a3\u8005\u7684\u751f\u6d3b\u8d28\u91cf\u300d\u8fd9\u4e00\u76ee\u6807\u3002<\/span>\u6d1b\u62c9\u66ff\u5c3c\u7684\u4e0d\u826f\u53cd\u5e94\u5305\u542b\uff1a\u9ad8\u7518\u6cb9\u4e09\u916f\u8840\u75c7\u548c\u9ad8\u80c6\u56fa\u9187\u8840\u75c7\u3001\u5468\u56f4\u795e\u7ecf\u75c5\u53d8\u3001\u6c34\u80bf\u548c\u836f\u7269\u76f8\u5173\u7684\u589e\u91cd\u3002<\/section>\n
<\/section>\n
\u5176\u4e2d\u6bd4\u8f83\u4e25\u91cd\u4e0d\u826f\u53cd\u5e94\u662f\u6d1b\u62c9\u66ff\u5c3c\u5bf9\u4e8e\u795e\u7ecf\u7cfb\u7edf\u529f\u80fd\u7684\u5f71\u54cd\uff0c\u5728 CROWN \u7814\u7a76\u4e2d\uff0c21% \u7684\u60a3\u8005\u51fa\u73b0\u8ba4\u77e5\u95ee\u9898\uff0c16% \u7684\u60a3\u8005\u51fa\u73b0\u4e0e\u60c5\u7eea\u76f8\u5173\u7684\u6d1b\u62c9\u66ff\u5c3c\u4e0d\u826f\u53cd\u5e94\u3002\u6839\u636e CROWN \u7814\u7a76\u6570\u636e\uff0c\u6d1b\u62c9\u66ff\u5c3c\u5728\u5168\u7403\u7684\u4f7f\u7528\u5e76\u672a\u5728\u4e34\u5e8a\u4e0a\u663e\u8457\u6539\u5584\u60a3\u8005\u751f\u6d3b\u8d28\u91cf\u8bc4\u5206\u3002<\/section>\n
<\/section>\n
<\/section>\n
\n
\n
\n
\n
ALK \u878d\u5408\u7a81\u53d8\u7c7b\u578b\u4e0e\u9776\u5411\u836f\u7269\u9009\u62e9<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n
<\/section>\n
EGFR \u7a81\u53d8\u5df2\u7ecf\u5b8c\u5168\u8d70\u5411\u4e86\u7cbe\u51c6\u5316\u6307\u5bfc\u6cbb\u7597\u7684\u9053\u8def\uff0c\u6211\u4eec\u8bf4 EGFR \u7a81\u53d8\u65f6\u9700\u6ce8\u660e\u60a3\u8005\u662f 19 \u4f4d\u5916\u663e\u5b50\u7f3a\u5931\u7a81\u53d8\u8fd8\u662f 21 \u4f4d L858R \u70b9\u7a81\u53d8\u8fd8\u662f 20 \u4f4d T790M \u70b9\u7a81\u53d8\uff0c\u8fd8\u662f\u5176\u4ed6\u975e\u5178\u578b\u7a81\u53d8\u3002\u4f46 ALK \u5b9e\u9645\u4e0a\u5c1a\u672a\u5b8c\u5168\u8d70\u5411\u7cbe\u51c6\u5316\u6cbb\u7597\u7684\u9053\u8def\u3002<\/section>\n
<\/section>\n
ALK \u57fa\u56e0\u878d\u5408\u8fc7\u7a0b\u4e2d\uff0cALK \u57fa\u56e0\u9700\u8981\u65ad\u88c2\uff0c\u5176\u65ad\u88c2\u70b9\u6bd4\u8f83\u4fdd\u5b88\uff0820 \u5916\u663e\u5b50\uff0c\u4e00\u822c\u62a5\u544a\u4f1a\u5199\uff1aALK:intron20\uff09\uff0c\u4f46\u5176\u878d\u5408\u4f34\u4fa3\u975e\u5e38\u591a\uff0c\u5728 NSCLC \u60a3\u8005\u4e2d\uff0cALK \u878d\u5408\u57fa\u56e0\u7684\u6700\u5e38\u89c1\u5206\u5b50\u4f34\u4fa3\u4e3a EML4 \u57fa\u56e0\uff0895% \u5de6\u53f3\uff09\uff0c\u5176\u4ed6\u878d\u5408\u5206\u5b50\u4f34\u4fa3\u8fd8\u6709 TFG\u3001KLC1\u3001SOCS5\u3001H1P1\u3001TPR\u3001BIRC6 \u7b49\u3002<\/section>\n
<\/section>\n
\u5373\u4f7f\u662f EML4 \u57fa\u56e0\uff0c\u4e5f\u6709\u5f88\u591a\u4e9a\u578b\uff0c\u622a\u81f3\u76ee\u524d\uff0c\u5df2\u7ecf\u53d1\u73b0\u4e86 15 \u79cd\u4ee5\u4e0a\u7684 EML-ALK \u878d\u5408\u53d8\u4f53\u4e9a\u578b\uff0c\u5176\u4e2d\uff0c\u6700\u5e38\u89c1\u7684\u662f EML4 \u7684\u53d8\u4f53 1\uff08\u901a\u5e38\u79f0\u4e3a v1; \u5916\u663e\u5b50 13 \u4e0e ALK \u7684\u5916\u663e\u5b50 20 \u878d\u5408 [E13;A20]\uff0c\u5360\u6bd4\u4e3a 43%\uff09\u548c EML4 \u7684\u53d8\u4f53 3v3a\/b\uff08\u901a\u5e38\u79f0\u4e3a v3\uff0cEML4 \u7684\u5916\u663e\u5b50 6a\/b \u4e0e ALK \u7684\u5916\u663e\u5b50 20 \u878d\u5408 [E6a\/b;A20]\uff0c\u5360\u6bd4\u4e3a 40%\uff09\u3002<\/section>\n
<\/section>\n
ALK \u878d\u5408\u7c7b\u578b\u4e0d\u540c\u5bf9\u836f\u7269\u53cd\u5e94\u4e5f\u662f\u4e0d\u540c\u7684\u3002\u4e00\u9879\u7814\u7a76\u663e\u793a ALK \u4e0d\u540c EML4 \u53d8\u4f53\u4e9a\u578b\u7684\u60a3\u8005\uff0c\u5bf9\u4e0d\u540c\u4ee3\u7684 ALK \u9776\u5411\u836f\u7269\u6cbb\u7597\u6709\u4e0d\u540c\u7684\u7597\u6548\uff0c\u6700\u5e38\u89c1\u7684 V1 \u548c V3 \u60a3\u8005\u63a5\u53d7\u514b\u5511\u66ff\u5c3c\u548c 2 \u4ee3 ALK \u6291\u5236\u5242<\/strong>\uff0cV1 \u60a3\u8005\u83b7\u76ca\u66f4\u5927\uff01<\/strong><\/section>\n
\u603b\u7ed3\u63a8\u8350<\/strong><\/p>\n
\n
<\/section>\n
\u603b\u7684\u6765\u8bf4\uff0c\u7b14\u8005\u975e\u5e38\u8ba4\u53ef NCCN \u5bf9\u6d1b\u62c9\u66ff\u5c3c\u7528\u4e8e ALK+\u665a\u671f NSCLC \u4e00\u7ebf\u63a8\u8350\u3002\u867d\u7136\u5c1a\u65e0\u5f3a\u5faa\u8bc1\u533b\u5b66\u8bc1\u636e\u7684 III \u671f\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u9a8c\u8bc1\uff0c\u4f46\u771f\u5b9e\u4e16\u754c\u7684\u7814\u7a76\u53ca II \u671f\u4e34\u5e8a\u7814\u7a76\u5747\u5df2\u8bc1\u660e\u4e86\u6d1b\u62c9\u66ff\u5c3c\u7528\u4e8e ALK+\u665a\u671f NSCLC \u7684\u4e8c\u7ebf\u53ca\u4ee5\u4e0a\u7597\u6548\uff0c\u800c\u4e14\u8003\u8651\u5230\u6d1b\u62c9\u66ff\u5c3c\u4e0a\u5e02\u65f6\u95f4\u8f83\u665a\u4e14\u524d\u671f\u672a\u8fdb\u533b\u4fdd\uff0c\u56fd\u5185\u76f8\u5f53\u4e00\u6279 ALK+NSCLC \u60a3\u8005\u5e76\u6ca1\u6709\u673a\u4f1a\u4e00\u7ebf\u4f7f\u7528\u6d1b\u62c9\u66ff\u5c3c\uff0c\u6240\u4ee5\u5bf9\u4e8e\u4f7f\u7528\u963f\u6765\u66ff\u5c3c\u8010\u836f\u7684 ALK+NSCLC \u60a3\u8005\uff0c\u7b14\u8005\u4e5f\u975e\u5e38\u63a8\u8350\u6d1b\u62c9\u66ff\u5c3c\u4f5c\u4e3a\u963f\u6765\u66ff\u5c3c\u8010\u836f\u540e\u7684\u4e8c\u7ebf\u836f\u7269\u9009\u62e9\u3002<\/section>\n
<\/section>\n
\u5bf9\u4e8e\u4e00\u7ebf\u7528\u836f\u662f\u9009\u62e9\u963f\u6765\u66ff\u5c3c\u8fd8\u662f\u6d1b\u62c9\u66ff\u5c3c\uff0c\u8003\u8651\u5230\u5728 ALEX \u7814\u7a76\u4e2d\uff0c\u963f\u6765\u66ff\u5c3c\u5bf9 EML4-ALK v1 \u53d8\u4f53\u8fbe\u5230\u4e86 90.9% \u7684\u6574\u4f53\u53cd\u5e94\u7387\uff0c\u4f46\u5bf9 EML4-ALK v3 \u53d8\u4f53\u7684\u53cd\u5e94\u7387\u4ec5\u4e3a 68.0%\uff0c\u56e0\u6b64\u963f\u6765\u66ff\u5c3c\u81f3\u5c11\u5bf9\u4e8e EML4-ALK V3 \u7c7b\u578b\u7684\u60a3\u8005\u7597\u6548\u662f\u6709\u6240\u6b20\u7f3a\u7684\u3002\u6240\u4ee5\u5bf9\u4e8e EML4-ALK V3 \u7c7b\u578b\u7a81\u53d8\uff0c\u7b14\u8005\u66f4\u52a0\u63a8\u8350\u6d1b\u62c9\u66ff\u5c3c\u4f5c\u4e3a\u4e00\u7ebf\u7528\u836f\u3002\u53e6\u5916\uff0c\u6d1b\u62c9\u66ff\u5c3c\u662f\u4e00\u79cd\u4e13\u95e8\u8bbe\u8ba1\u7528\u4e8e\u5b9e\u73b0\u9ad8\u6c34\u5e73\u7684\u4e2d\u67a2\u795e\u7ecf\u7cfb\u7edf (CNS) \u6e17\u900f\u7684\u5927\u73af ALK TKI\uff0c\u5176\u5bf9\u8111\u8f6c\u79fb\u6cbb\u7597\u66f4\u52a0\u7a81\u51fa\uff0c\u6240\u4ee5\u5bf9\u4e8e\u5df2\u8111\u8f6c\u79fb ALK+NSCLC \u60a3\u8005\uff0c\u7b14\u8005\u4e5f\u52a0\u63a8\u8350\u6d1b\u62c9\u66ff\u5c3c\u4f5c\u4e3a\u4e00\u7ebf\u7528\u836f\u3002<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n","protected":false},"excerpt":{"rendered":"

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