【摘要】 目前，随着基因靶向治疗和免疫治疗在肺癌领域中取得巨大突破，晚期肺癌患者总生存期(OS)显著延长，但发生远处骨转移及骨相关事件(SRE),如骨痛、病理性骨折、脊髓压迫、高钙血症等风险也随之增大，严重影响了患者的生活质量。因此，在全身治疗基础上应积极预防和治疗骨转移及SRE治疗。临床研究表明，核因子κB受体活化因子(RANK)配体(RANKL)/RANK/骨保护素信号通路在肿瘤骨转移中发挥着重要作用，阻断该通路能有效预防和治疗SRE。RANKL抑制剂地舒单抗(商品名：安加维)是一种人免疫球蛋白G2单克隆抗体，可特异性结合RANKL而阻断破骨细胞参与的RANKL/RANK/骨保护素信号通路激活，最终发挥预防骨转移及SRE的作用。与双磷酸盐类药物比较，地舒单抗疗效显著，能明显延长患者OS和SRE的发生时间。同时，地舒单抗还具有抗肿瘤作用。该文就地舒单抗的作用机制、临床研究及安全性等方面的最新研究进行了阐述，以期为临床医生提供参考。更多还原

【Abstract】 At present, with the great breakthrough of gene targeted therapy and immunotherapy in the field of lung cancer, the overall survival(OS) of patients with advanced lung cancer has been significantly prolonged, however, there is an increased risk of distant bone metastases and skeletal related events(SRE),such as bone pain, pathological fractures, spinal cord compression and hypercalcemia, which has seriously affected patients′ quality of life.Therefore, on the basis of systemic therapy, bone metastasis and SRE should be actively prevented and treated.Clinical studies have shown that receptor activator of the nuclear factor-kappa B ligand(RANKL)/receptor activator nuclear factor-κB(RANK)/osteoprotegerin(OPG) signaling pathway plays an important role in tumor bone metastasis, and blocking this pathway can prevent and treat SRE.RANKL inhibitor Denosumab is a human immunoglobulin G2(IgG2) monoclonal antibody that specifically binds RANKL and blocks the activation of RANKL/RANK/OPG signaling pathway involved by osteoclasts, and finally play a role in preventing bone metastasis and SRE.Compared with bisphosphonates, Denosumab has significant efficacy and can significantly prolong the OS and the occurrence time of SRE.At the same time, Denosumab also has anti-tumor effects.This article reviews the latest research on the mechanism of action, clinical research and safety of Denosumab, in order to provide reference for clinicians.更多还原