EGFR编码的蛋白是一种跨膜糖蛋白,也是表皮生长因子受体家族中的一员,该家族包括HER1(erbB1,EGFR)、HER2(erbB2,NEU)、HER3(erbB3)及HER4(erbB4),也属于受体酪氨酸激酶家族。EGFR作为细胞表面蛋白可与配体如表皮生长因子(EGF)结合,EGFR可被激活,由单体转化为二聚体以及发生自体酪氨酸磷酸化,激活后的EGFR可以再磷酸化下游蛋白,包括调控细胞存活的PI3K-AKT-mTOR信号通路 和调控细胞增殖的RAS-RAF-MEK-ERK信号通路,EGFR的突变和表达水平的升高与多种癌症相关,其中肺癌最为常见。
| 基因名: | EGFR |
| 别名: | ERBB,ERBB1,HER1,NISBD2,PIG61,mENA |
| 基因ID: | 1956 |
| Chromosome: (GRCh37) | 7 Start: 55086714 End: 55324313 Strand: 1 |
| 药物: | 氟尿嘧啶 AEE788 阿法替尼 贝伐单抗,贝伐珠单抗 博舒替尼 布加替尼 布格替尼 布吉他滨 帕尼单抗 西妥昔单抗 卡奈替尼 顺铂 克唑替尼 CRS/IPHC 达可替尼 达克替尼 多西他赛 EGFR Inhibitor 厄洛替尼 吉非替尼 埃克替尼 拉帕替尼 度伐利尤单抗,德瓦鲁单抗 来那替尼,奈拉替尼 尼妥珠单抗 奥希替尼 培美曲塞 PF 00299804 PLATINUM 替西罗莫司/坦西莫司 Rintega Rociletinib 星形孢菌素 Sym004 莫博赛替尼,莫博替尼 |
eGFRt790M是公认的最早对非小细胞肺癌靶向治疗产生耐药性的突变之一。尽管第一代和第二代tki(erlotinib、gefitinib、neratinib)成功扩增了egfr,但治疗前治疗携带这种突变的患者的疗效却显著降低。与野生型egfr或其他类型egfr突变患者相比,这种疗效的缺乏可能是导致这种突变患者预后较差的原因。大约一半获得性抗tki抑制的egfr突变肿瘤被证明含有这种突变,这意味着它是获得性治疗抵抗的机制。第三代TKI(Osimertinib)已被批准用于治疗EGFR T790M突变型NSCLC。血浆试验中T790M阳性的患者与肿瘤活检试验结果相似。
EGFR T790M was one of the very first mutations recognized to confer resistance to targeted therapies in non-small cell lung cancer. While successful in amplified EGFR, the efficacy of the first and second generation TKI's (erlotinib, gefitinib, neratinib) in treating patients harboring this mutation before treatment is notably lower. This lack of efficacy can likely be to blame for the poorer prognosis for patients with this mutation as compared to patients with wildtype EGFR or other types of EGFR mutations. Approximately half of EGFR mutant tumors with acquired resistance to TKI inhibition have been shown to harbor this mutation, implicating it as a mechanism of acquired therapy resistence. A third generation TKI (osimertinib) has been approved for the treatment of EGFR T790M mutant NSCLC. Patients positive for T790M in a plasma-based test have similar outcomes like those with tumor biopsy testing.
| Chr. | Start | Stop | Ref. s | Var. Bases |
| 7 | 55249071 | 55249071 | C | T |
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