medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2018-19-130-135medsovet-2761Research ArticleКЛИНИЧЕСКОЕ НАБЛЮДЕНИЕCLINICAL OBSERVATIONФенотипическая трансформация как причина вторичной лекарственной резистентности к осимертинибу. Клиническое наблюдениеPhenotypic transformation as a cause of secondary drug resistance to osimetinib clinical observationНелюбинаЛ. А.NelyubinaL. A.

к.м.н., научный сотрудник отделения хирургического №13 (клинических биотехнологий)

РеутоваЕ. В.ReutovaE. V.

к.м.н., старший научный сотрудник отделения хирургического №13 (клинических биотехнологий)

ЛактионовК. К.LaktionovK. K.

д.м.н., заместитель директора по лечебной работе Научно-исследовательского института клинической онкологии им. академика РАН и РАМН Н.Н. Трапезникова, и.о. зав. отделением хирургическим №13 (клинических биотехнологий) торако-абдоминального отдела

ЮдинД. И.YudinD. I.

к.м.н., старший научный сотрудник отделения хирургического №13 (клинических биотехнологий)

МариновД. Т.MarinovD. T.

к.м.н., ведущий научный сотрудник отделения хирургического №13 (клинических биотехнологий)

КозакЕ. Н.KozakE. N.

врач-рентгенолог рентгенодиагностического отделения НИИ клинической и экспериментальной радиологии

МочальниковаВ. В.MochalnikovaV. V.

врач-патологоанатом отделения патологической анатомии опухолей человека

ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава РоссииРоссияBlokhin Russian Cancer Research Center of the Ministry of Health of Russia, MoscowRussian Federation201811112018019130135Copyright © Нелюбина Л.А., Реутова Е.В., Лактионов К.К., Юдин Д.И., Маринов Д.Т., Козак Е.Н., Мочальникова В.В., 20182018Нелюбина Л.А., Реутова Е.В., Лактионов К.К., Юдин Д.И., Маринов Д.Т., Козак Е.Н., Мочальникова В.В.Nelyubina L.A., Reutova E.V., Laktionov K.K., Yudin D.I., Marinov D.T., Kozak E.N., Mochalnikova V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/2761

Оптимальным методом лечения больных с распространенным EGFR-позитивным НМРЛ является таргетная терапия. Ингибиторы тирозинкиназ EGFR 1-го и 2-го поколения обеспечивают стойкий противоопухолевый ответ у большинства пациентов в течение года. При прогрессировании болезни, обусловленном появлением вторичной мутации резистентности Т790М, назна чение осимертиниба дает возможность добиться контроля над опухолью еще на 10 мес. Однако это не единственный механизм приобретенной лекарственной устойчивости. Повторная биопсия опухоли с последующим гистологическим и молекулярно-генетическим исследованием позволяет уточнить причину резистентности и персонифицировать дальнейшую лечебную тактику.

Targeted therapy is the optimal treatment of patients with advanced EGFR-positive NSCLC. The first- and second-generation EGFR tyrosine kinase inhibitors provide a durable antitumor response in most patients during the year. Due to appearance of T790M secondary mutation of resistance at progression of the disease, the administration of osimertinib leads to full control of the tumour for another 10 months. However, this is not the only mechanism of acquired drug resistance. A repeated biopsy of the tumour followed by histological and molecular genetic research makes it possible to clarify the cause of resistance and personalize the further disease management.

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The authors declare that there are no conflicts of interest present.