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Title	ドライバー遺伝子変異を標的とした肺がん治療
Subtitle	特集肺がんに対する薬物治療
Authors	前門戸任, 秋山真親
Authors (kana)
Organization	*岩手医科大学内科学講座呼吸器内科分野
Journal	医学と薬学
Volume	78
Number	6
Page	707-716
Year/Month	2021 / 6
Article	報告
Publisher	自然科学社
Abstract	「はじめに」現在の肺がん治療において分子標的治療薬は殺細胞薬, 免疫療法とならびメインの全身性抗がん療法の一つである. EGFR遺伝子変異, ALK融合遺伝子転座の発見に続き, ROS1融合遺伝子転座, BRAF遺伝子変異, METexon14 skippingに適合する分子標的治療薬が上市され, 今後RET融合遺伝子など複数の分子標的薬が承認される予定である. 本稿ではドライバー遺伝子変異それぞれに対する治療を概説する. 「I EGFR遺伝子陽性肺がん」「1. EGFR遺伝子変異」 2002年に上皮成長因子受容体・チロシンキナーゼ阻害薬(EGFR-TKI)であるゲフィチニブが上市された後, 2004年に劇的に効果を発揮する患者が活性型EGFR遺伝子変異を有することが判明した. このEGFR遺伝子変異の頻度は西欧諸国では5～15%であるのに比較して本邦では30～50%の患者に認められる. EGFR遺伝子変異には活性型遺伝子変異と後述する耐性遺伝子変異があり, 活性型遺伝子変異にはエクソン19欠失変異とエクソン21点突然変異L858Rのcommon mutationがあり, この二つの変異で80～90%を占める.
Practice	医学総合
Keywords	非小細胞肺がん, 分子標的薬, ドライバー遺伝子変異

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