据研究发现克唑替尼的耐药机制主要表现在两方面，一是由于ALK融合基因被激活扩增使得药物治疗失败，这个称为原发性耐受；二是由于ALK基因二次突变让NSCLC患者对克唑替尼的药物敏感度降低甚至是无效，这个称为继发性耐药。服用克唑替尼期间出现耐药反应了？不用怕！看下去你就知道该怎么应对了！

According to studies, the drug resistance mechanism of crizotinib is mainly manifested in two aspects. One is the failure of drug treatment due to the activation and amplification of ALK fusion gene, which is called primary tolerance. Second, secondary mutations of ALK gene make NSCLC patients less sensitive to crizotinib drugs or even ineffective, which is called secondary drug resistance. Did you have a drug resistance during crizotinib? Don't be afraid! Watch and you will know how to deal with it!

　　若患者已经对克唑替尼产生耐药但尚未发生脑转移的话，可以考虑选用同样是针对ALK阳性突变的二代药物色瑞替尼进行治疗。其临床推荐服用剂量是750mg，每天空腹温水送服口服一次，一次服5粒（规格是150mg/粒）。

　　若患者在对克唑替尼产生耐药的情况下还发生了脑转移，则可以选择服用布格替尼AP26113来控制脑转移的进展。布格替尼也是被美国FDA批准用于克唑替尼耐药后ALK突变非小细胞肺癌患者的靶向药，经临床试验研究发现对脑转移有效缓解率高达67％。其临床推荐服用剂量是90mg，一天一次，一次一粒（规格是90mg/粒）。

　　服用克唑替尼产生耐药反应后不用害怕，一定要立即告诉医生自己的任何不适，听从医生建议进行相关检查，并好好配合医生推荐的用药方案，只有真正遵医嘱服药治疗，才能最大程度地减少因耐药带来的疾病伤害。

After taking crizotinib for drug resistance reaction, do not be afraid, must immediately tell the doctor any discomfort, follow the doctor's advice for relevant examination, and cooperate with the doctor's recommended drug regimen, only really follow the doctor's advice to take medicine treatment, can reduce the disease injury caused by drug resistance to the greatest extent.