Non-small-cell lung cancer (NSCLC) with comorbid interstitial pneumonia (IP) is a population with limited treatment options and a poor prognosis. Patients with comorbid IP are at high risk of developing fatal drug-induced pneumonitis, and data on the safety and efficacy of molecularly targeted therapies are lacking.KRASmutations have been frequently detected in patients with NSCLC with comorbid IP. However, the low detection rate of common driver gene mutations, such as epidermal growth factor receptor and anaplastic lymphoma kinase, in patients with comorbid IP frequently results in inadequate screening for driver mutations, andKRASmutations may be overlooked. Recently, sotorasib and adagrasib were approved as treatment options for advanced NSCLC withKRASG12Cmutations. Although patients with comorbid IP were not excluded from clinical trials of theseKRASG12Cinhibitors, the incidence of drug-induced pneumonitis was low. Therefore,KRASG12Cinhibitors may be a safe and effective treatment option for NSCLC with comorbid IP. This review article discusses the promise and prospects of molecular-targeted therapies, especiallyKRASG12Cinhibitors, for NSCLC with comorbid IP, along with our own clinical experience.
合并间质性肺炎的非小细胞肺癌患者治疗选择有限且预后不良。此类患者发生致命性药物性肺炎的风险较高，目前尚缺乏分子靶向治疗在此类人群中的安全性与疗效数据。在合并间质性肺炎的非小细胞肺癌患者中，KRAS基因突变检出频率较高。然而，由于此类患者中表皮生长因子受体、间变性淋巴瘤激酶等常见驱动基因突变检出率较低，常导致驱动基因筛查不充分，可能造成KRAS突变被忽视。近期，索托拉西布与阿达格拉西布已获批用于治疗携带KRAS G12C突变的晚期非小细胞肺癌。尽管相关临床试验未排除合并间质性肺炎的患者，但药物性肺炎发生率较低。因此，KRAS G12C抑制剂可能成为此类患者安全有效的治疗选择。本文结合临床实践经验，探讨分子靶向治疗特别是KRAS G12C抑制剂在合并间质性肺炎的非小细胞肺癌治疗中的应用前景。
肿瘤(癌症)患者之家