晚期非小细胞肺癌 EGFR敏感突变型患者酪氨酸激酶<br/>抑制药的疗效和安全性

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (500 KB)
输出: BibTeX | EndNote (RIS)

摘要目的观察晚期非小细胞肺癌表皮生长因子受体(EGFR)敏感突变型患者酪氨酸激酶抑制药(EGFR-tyrosine-kinase inhibitor,EGFR- TKI)的疗效和安全性。方法 32例EGFR敏感突变型晚期非小细胞肺癌患者一线化疗后给予EGFR- TKI维持治疗。观察近期疗效、无进展生存期(progression-free-survival, PFS)、总生存期(overall survival, OS)及不良反应。结果全组CR 3例,PR 7例,SD 18例,PD 4例。有效率 RR 31.3%,疾病控制率DCR 87.5 %;中位PFS 14.9个月(95% CI:11.93 ~17.87个月);中位OS 25.1个月(95% CI:20.8~29.3个月)。全组无重度不良反应发生,治疗耐受良好。皮疹发生率37.5%,腹泻发生率15.6%。结论晚期非小细胞肺癌 EGFR敏感突变型患者EGFR- TKI维持治疗安全有效。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	曹京旭
	李韧
	俞立权
	苏丹
	徐阳
	布洁

关键词 ：非小细胞肺癌, 酪氨酸激酶抑制药, 维持治疗

Abstract：Objective To investigate the efficacy and safety of EGFR-tyrosine-kinase inhibitor(EGFR-TKI)as maintenance therapy in patients with advanced non-small-cell lung cancer (NSCLC) and positive EGFR mutation. Methods Thirty-two patients who suffered from advanced NSCLC with EGFR mutation-positive were given EGFR-TKIS (Gefitinib, Taceva or Icotinib) as maintenance therapy following first-line chemotherapy and no disease progression. Clinical efficacy, progression-free survival (PFS), overall survival (OS) and adverse events were analyzed. Results Complete remission(CR), partial remission(PR), stable disease(SD) and progressing disease(PD)were observed in 3, 7, 18 and 4 cases, respectively. Response rate (RR) was 31.3% and disease control rate (DCR) was 87.5% in the group. Median PFS was 14.9 months(95% CI:11.93~17.87) and mOS was 25.1 months (95% CI:20.8~29.3). The most common adverse events were rash (37.5%) and diarrhea (15.6%). Conclusions EGFR-TKIs as maintenance therapy in the patients with advanced NSCLC and EGFR mutation-positive is effective and safe.

Key words： non-small-cell lung cancer EGFR-tyrosine-kinase inhibitor maintenance therapy

收稿日期: 2015-03-25

ZTFLH:

R734.2

通讯作者: 布洁,E-mail: bujie68@163.com E-mail: cao.jv@163.com

作者简介: 曹京旭, 本科学历,主任医师

引用本文:

曹京旭,李韧,俞立权,苏丹,徐阳,布洁. 晚期非小细胞肺癌 EGFR敏感突变型患者酪氨酸激酶
抑制药的疗效和安全性[J]. 武警医学, 2015, 26(10): 988-990. CAO Jingxu, LI Ren, YU Liquan, SU Dan, XU Yang, and BU Jie. EGFR-TKI maintenance therapy for advanced non-small-cell lung cancer with positive EGFR mutation. Med. J. Chin. Peop. Armed Poli. Forc., 2015, 26(10): 988-990.

链接本文:

http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2015/V26/I10/988

[1]	Siegel R, Miller K, Jemal A. Cancer statistics:2015[J]. CA Cancer J Clin, 2015, 65(1): 5-29.
[2]	支修益,石远凯,于金明.中国原发性肺癌诊疗规范[J].中华肿瘤杂志,2015,37(1):67-78.
[2]	支修益,石远凯,于金明.中国原发性肺癌诊疗规范[J].中华肿瘤杂志,2015,37(1):67-78.
[3]	Ramalingam S, Belani C P. Systemic chemotherapy for advanced non-small cell lung cancer: recent advances and future directions [J]. J Oncologist, 2008, 13(suppl1): 5-13.
[3]	Ramalingam S, Belani C P. Systemic chemotherapy for advanced non-small cell lung cancer: recent advances and future directions [J]. J Oncologist, 2008, 13(suppl1): 5-13.
[4]	Marino P, Pampallona S, Preatoni A, et al. Chemo-therapy vs supportive care in advanced non-cell lung cancer: Results of a meta-analysis of the literature [J]. Chest, 1994,106(3):861-865.
[4]	Marino P, Pampallona S, Preatoni A, et al. Chemo-therapy vs supportive care in advanced non-cell lung cancer: Results of a meta-analysis of the literature [J]. Chest, 1994,106(3):861-865.
[5]	Pirker R, Pereial J, Szczesna A, et al. Cetuximab plus chemotherapy in patients with advanced non-small-cell lung cancer (FLEX) open-label randomized phase Ⅲ trial [J]. Lancet, 2009, 373(9674): 1525-1531.
[5]	Pirker R, Pereial J, Szczesna A, et al. Cetuximab plus chemotherapy in patients with advanced non-small-cell lung cancer (FLEX) open-label randomized phase Ⅲ trial [J]. Lancet, 2009, 373(9674): 1525-1531.
[6]	Perol M, Chouaid C, Milleron B J, et al. Maintenance with either gemcitabine or erlotinib versus observation with predefined second-line treatment after cisplatin-gemcitabine induction chemotherapy in advanced NSCLC: IFCT-GFPC 0502 phase 3 study [J]. Clin Oncol, 2010,28(suppl):540s.
[7]	李艳,郭其森. 晚期非小细胞肺癌维持治疗进展[J]. 中华肿瘤防治杂志, 2014, 21 (10): 800-804.
[6]	Perol M, Chouaid C, Milleron B J, et al. Maintenance with either gemcitabine or erlotinib versus observation with predefined second-line treatment after cisplatin-gemcitabine induction chemotherapy in advanced NSCLC: IFCT-GFPC 0502 phase 3 study [J]. Clin Oncol, 2010,28(suppl):540s.
[7]	李艳,郭其森. 晚期非小细胞肺癌维持治疗进展[J]. 中华肿瘤防治杂志, 2014, 21 (10): 800-804.
[8]	Brodowicz T, Krzakowski M , Zwitter M, et al. Cisplatin and gemcitabine first-line chemotherapy followed by maintenance gemcitabine or best supportive care in advanced non-small cell lung cancer: a phase Ⅲ trial [J]. Lung Cancer, 2006, 52: 155-163.
[8]	Brodowicz T, Krzakowski M , Zwitter M, et al. Cisplatin and gemcitabine first-line chemotherapy followed by maintenance gemcitabine or best supportive care in advanced non-small cell lung cancer: a phase Ⅲ trial [J]. Lung Cancer, 2006, 52: 155-163.
[9]	Stinchcombe T, Socinski M. Maintenance therapy in advanced non-small cell lung cancer: current status and future implications [J]. J Thorac Oncol, 2011, 6(1): 174-182.
[9]	Stinchcombe T, Socinski M. Maintenance therapy in advanced non-small cell lung cancer: current status and future implications [J]. J Thorac Oncol, 2011, 6(1): 174-182.
[10]	Ciuleanu T, Brodowicz T, Zielinski C, et al. Manintenance pemetrexed plus best supportive care versus placebo plus best supportive care for non-small-cell lung cancer: a randomized double-blind, phase 3 study [J]. Lancet, 2009, 374: 1432-1440.
[10]	Ciuleanu T, Brodowicz T, Zielinski C, et al. Manintenance pemetrexed plus best supportive care versus placebo plus best supportive care for non-small-cell lung cancer: a randomized double-blind, phase 3 study [J]. Lancet, 2009, 374: 1432-1440.
[11]	Goldie J H, Colkman A J. A mathematical model for relating the drug sensitivity of tumors to their spontaneous mutation rate[J] . Cancer Treat Rep, 1979, 63(11-12): 1727-1733.
[11]	Goldie J H, Colkman A J. A mathematical model for relating the drug sensitivity of tumors to their spontaneous mutation rate[J] . Cancer Treat Rep, 1979, 63(11-12): 1727-1733.
[12]	Fidias P M, Dakhil R, Lyss P, et al. Ⅲ study of immediate compared with delayed docetaxal after front-line therapy with gemeitabine plus carboplatin in advanced non-small-cell lung cancer[J]. J Clin Oncol, 2009, 27(4):591-598.
[12]	Fidias P M, Dakhil R, Lyss P, et al. Ⅲ study of immediate compared with delayed docetaxal after front-line therapy with gemeitabine plus carboplatin in advanced non-small-cell lung cancer[J]. J Clin Oncol, 2009, 27(4):591-598.
[13]	Mencoboni M, Bergaglio M, Serra M, et al. Maintenance therapy with gefitinib after first-line chemotherapy in patients affected by advanced non-small cell lung cancer[J]. Anticancer Res, 2007, 27(6c): 4425-4429.
[13]	Mencoboni M, Bergaglio M, Serra M, et al. Maintenance therapy with gefitinib after first-line chemotherapy in patients affected by advanced non-small cell lung cancer[J]. Anticancer Res, 2007, 27(6c): 4425-4429.
[14]	Zhou C, Wu Y L, Chen C, et al. Updated efficacy and quality of life (Qol) analyses in OPTIMAL, a phase 3, randomized, open-label study of first-line erlotinib vs gemcitabine/carboplatin in patients with EGFR activating-mutation positive(EGFR Act Mut+) advanced non-small cell lung cancer (NSCLC) [J]. J Clin Oncol,29(suppl): 2011.
[14]	Zhou C, Wu Y L, Chen C, et al. Updated efficacy and quality of life (Qol) analyses in OPTIMAL, a phase 3, randomized, open-label study of first-line erlotinib vs gemcitabine/carboplatin in patients with EGFR activating-mutation positive(EGFR Act Mut+) advanced non-small cell lung cancer (NSCLC) [J]. J Clin Oncol,29(suppl): 2011.
[15]	Maemondo M, Inoue A, Kobayashi K, et al. Cefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR[J]. N Engl J Med, 2010, 362(25): 2380-2388.
[15]	Maemondo M, Inoue A, Kobayashi K, et al. Cefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR[J]. N Engl J Med, 2010, 362(25): 2380-2388.
[16]	Mok T S , Wu Y L, Thongprasert S, et al. Gefitinib or carboplatin- paclitaxel in pulmonary adenocarcinoma [J]. N Engl J Med,2009, 361(10):947 - 957.
[16]	Mok T S , Wu Y L, Thongprasert S, et al. Gefitinib or carboplatin- paclitaxel in pulmonary adenocarcinoma [J]. N Engl J Med,2009, 361(10):947 - 957.
[17]	Zhou C, Wu Y L, Chen G, et al. Erlotinib versus Chemotherapy as first-line treatment for Patients with advanced EGFR mutation - positive non-small-cell lung cancer (OPTIMAL,CTONG-0802): a multicentre, open-label, randomized, phase 3 study [J]. Lancet Oncol, 2011, 12(18): 735-742.
[17]	Zhou C, Wu Y L, Chen G, et al. Erlotinib versus Chemotherapy as first-line treatment for Patients with advanced EGFR mutation - positive non-small-cell lung cancer (OPTIMAL,CTONG-0802): a multicentre, open-label, randomized, phase 3 study [J]. Lancet Oncol, 2011, 12(18): 735-742.
[18]	Cappuzzo F, Ciuleanu T, Stelmakh L, et al. Erlotinib as maintenance treatment in advanced non-small-cell lung caner:A multicentre, randomized , placebo-controlled phase 3 study[J]. Lancet Oncol, 2010, 11(6): 521-529.
[18]	Cappuzzo F, Ciuleanu T, Stelmakh L, et al. Erlotinib as maintenance treatment in advanced non-small-cell lung caner:A multicentre, randomized , placebo-controlled phase 3 study[J]. Lancet Oncol, 2010, 11(6): 521-529.
[19]	钱晓涛,赵腊梅,何圆,等. 吉非替尼维持治疗晚期非小细胞肺癌的疗效[J]. 实用临床医学,2014, 15(9):5-14.
[19]	钱晓涛,赵腊梅,何圆,等. 吉非替尼维持治疗晚期非小细胞肺癌的疗效[J]. 实用临床医学,2014, 15(9):5-14.
[20]	Zhang L, Shenglin M, Song X, et al. Efficacy, tolerability, and biomarker analyses from a phase III, randomized, placebo-controlled, parallel group study of gefitinib as maintenance therapy in patients with locally advanced or metastatic non-small cell lung cancer(INFORM; C-TONG 0804)[J]. J Clin Oncol, 2011, 29(Suppl:Abstract):7511.
[20]	Zhang L, Shenglin M, Song X, et al. Efficacy, tolerability, and biomarker analyses from a phase III, randomized, placebo-controlled, parallel group study of gefitinib as maintenance therapy in patients with locally advanced or metastatic non-small cell lung cancer(INFORM; C-TONG 0804)[J]. J Clin Oncol, 2011, 29(Suppl:Abstract):7511.