Traditional Chinese Medicine reverses resistance to epidermal growth factor receptor tyrosine kinase inhibitors in advanced non-small cell lung cancer: a narrative review

J Tradit Chin Med. 2021 Aug;41(4):650-656. doi: 10.19852/j.cnki.jtcm.2021.03.017.

Abstract

Objective: To review mechanisms of the resistance to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in the treatment of non-small cell lung cancer and the reversal of this resistance by traditional Chinese herbal medicines (CHMs).

Methods: Searching China National Knowledge Infrastructure Database, Wanfang Database, China Science and Technology Journal Database, PubMed and Embase for related researches RESULTS: T790M mutation, MET amplification, C797S mutation, Inactivation of PTEN gene expression and Epithelial-mesenchymal transition (EMT) are the main mechanisms of the resistance to EGFR-TKIs. CHMs may reverse the resistance by inhibiting MET activation, inhibiting PI3K/AKT pathways, regulating apoptosis and P-glycoprotein (P-gp).

Conclusion: Many resistance mechanisms of EGFR-TKIs in the treatment of non-small cell lung cancer still need to be explored. CHMs have great research potential in reversing the resistance to EGFR-TKIs.

Keywords: Carcinoma, non-small-cell lung; Drug resistance; ErbB receptor; Herbal medicine.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Carcinoma, Non-Small-Cell Lung* / genetics
  • Drug Resistance, Neoplasm / genetics
  • ErbB Receptors / genetics
  • Humans
  • Lung Neoplasms* / drug therapy
  • Lung Neoplasms* / genetics
  • Medicine, Chinese Traditional
  • Mutation
  • Phosphatidylinositol 3-Kinases
  • Protein Kinase Inhibitors / pharmacology

Substances

  • Protein Kinase Inhibitors
  • ErbB Receptors