目的：肺癌是世界范围内常见的恶性肿瘤，非小细胞肺癌（ NSCLC ）是肺癌的主要组织学类型，约占80％。晚期NSCLC患者内科治疗获益有限。近些年来，针对表皮生长因子受体（EGFR）的小分子靶向药物酪氨酸激酶抑制剂（ TKI）在晚期NSCLC治疗中的地位得到了肯定。然而，并不是所有的NSCLC患者对TKI敏感。一方面，非EGFR敏感突变的患者对TKI原发耐药；另一方面，即使EGFR敏感突变的患者，仍有20％～30％的患者对TKI原发性耐药。文章对晚期NSCLC患者TKI原发性耐药的现状和机制进行了分析。%Lung cancer is one of the most common cancers worldwide .Non-small-cell lung cancer ( NSCLC ) accounts for approximately 80%of all lung cancers .Chemotherapy for patients with advanced NSCLC has only marginally improved overall survival;whereas recently developed small-molecule compound epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) demonstrate strong efficacy in treating advanced NSCLC .However , only a part of patients with NSCLC is sensitive to the treatment of EGFR TKIs if they have certain mutations of EGFR gene in their tumors .Patients without EGFR mutations show innate resistance to EGFR TKIs .Furthermore, approximately 20%-30%of patients with EGFR mutations also do not response to EGFR TKIs .In this review, the mechanisms underlying the primary resistance to EGFR TKIs in advanced NSCLC , especially in those with EGFR sensitive mutations , are summarized .
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