Фенотипическая трансформация как причина вторичной лекарственной резистентности к осимертинибу. Клиническое наблюдение

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.

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