Study on dosage adjustment and resistance mechanism of Mobotinib (Mobosetinib)

Mobocertinib is a targeted therapy specifically designed to treat patients with non-small cell lung cancer (NSCLC) carrying EGFR exon 20 insertion mutations. In practical applications, in order to achieve the best therapeutic effect and minimize toxic and side effects, reasonable dosage adjustment is particularly important. The recommended standard starting dose of mobotinib is 160 mg orally once daily. For some patients who experience severe adverse reactions, such as diarrhea, rash, or prolonged QT interval, doctors may reduce the dose to 120 mg or even 80 mg in stages according to the degree of response to improve patient tolerance and maintain treatment continuity.

In addition to dose adjustment, understanding the resistance mechanism of mobotinib is also an important direction for optimizing treatment strategies. As treatment time increases, some patients will experience disease progression, even if they respond well in the early stages. Studies have shown that drug resistance may be related to the emergence of other mutations in the EGFR pathway, such as T790M mutation, MET amplification or activation of downstream signaling pathways (such as the PI3K/AKT pathway). In addition, tumor cells may escape the inhibitory effect of mobotinib through phenotypic transformation (such as epithelial-to-mesenchymal transition). These mechanisms prompt researchers to continuously explore more sophisticated combination drug strategies or the development of next-generation inhibitors.

When dealing with drug resistance, individualized treatment becomes key. On the one hand, dynamic genetic testing of patients before and during medication is required to promptly discover potential drug-resistant mutations or changes in signaling pathways, thereby guiding medication changes or combined medication. On the other hand, doctors should closely monitor patients' clinical responses and imaging results to evaluate the sustainability of the drug's efficacy. Once there are signs of decreased efficacy, it should be immediately evaluated whether it is due to drug resistance, and the treatment plan should be adjusted in a timely manner.

In short, Mobotinib, as an innovative drug targeting EGFR exon 20 insertion mutations, has played an important role in the treatment of advanced NSCLC. Through scientific dose management and in-depth research on drug resistance mechanisms, more precise, efficient and lasting therapeutic effects can be achieved in clinical practice, bringing longer survival benefits and better quality of life to patients.

References：https://en.wikipedia.org/wiki/Mobocertinib