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吉非替尼记名供药计划治疗晚期复发非小细胞肺癌的疗效和预后因素分析 被引量:16

Analysis of the efficacy and safety of gefitinib in the treatment of recurrent advanced non-small cell lung cancer in an expanded access program ( EAP )
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摘要 目的研究吉非替尼治疗中国晚期非小细胞肺癌(NSCLC)患者的安全性和疗效。方法2002年9月至2005年3月共人选晚期复发NSCLC患者120例,其中可评价疗效者103例。给予吉非替尼口服每次250mg,每天1次,用药1个月后首次进行影像学疗效评价,此后每2~3个月复查影像学,直至出现病情进展或出现不能耐受的不良反应。停止吉非替尼治疗后,每6个月随访1次,直至患者死亡或随访结束。结果103例患者的客观有效率为18.4%(19/103),疾病控制率为51.5%(53/103),中位疾病进展时间(TTP)为3个月(0.2~40个月),中位牛存时间(MST)为9.8个月(0.5—51个月),1、2和3年生存率分别为44.7%、26.4%和13.2%。令组共有41例患者的.TTP≥6个月,其MST为25.5个月。Cox多因素分析显示,腺癌、治疗后出现皮疹、体力状态(PS)评分〈2分的患者具有更长的TTP,而PS评分〈2分、扶得疾病控制的患者具有更长的生存期。本组患者的不良反应主要为皮疹、皮肤干燥、腹泻和转氨酶升高,多为Ⅰ~Ⅱ度。结论古非替尼对于部分晚期复发的NSCLC患者有效,部分疾病拎制者具有较长的牛存期,而不良反应可耐受。 Objective The aim of this study is to evaluate the efficacy and safety of Gefitinib in the treatment of Chinese patients with recurrent advanced non-small-cell lung cancer (NSCLC). Methods 120 patients were enrolled in this trial from September 2002 to March 2005, and 103 patients were evaluable. All patients were histologically or/and cytologically confirmed to have a locally advanced or metastatic NSCLC, and failed to previous standard treatments. The patients received orally 250 mg of Gefitinib once daily until the disease progression or intolerance to toxicity. First evaluation of response was undertaken one month after drug initiation, then every 2 or 3 months till disease progression. Each patient was followed up every 6 months untill death or end of follow-up. Results Among the 103 evaluable patients, the objective response rate was 18.4% (19/103), and the disease control rate was 51.5% (53/103). The median time to progression (m3TP) was 3 months (range: 0.2 -40), the median survival time (MST) was 9.8 months ( range : 0.5 - 51 ), the 1 -, 2-, 3-year survival rates were 44.7% , 26.4% and 13.2% , respectively. The TIP of 41 patients was longer than 6 months with a MST of 25.5 months. The results of COX model analysis suggested that the patients with adenocarcinoma, rash and favourable performance status (PS) had longer TIP. The patients with favourable PS and well controlled disease had longer survival time. Adverse events included skin rash, dry skin, diarrhea and elevation of serum glutamate pyruvate transaminase (SGPT) , and were usually mild. Conclusion Gefitinib is effective in treatment of patient with recurrent advanced NSCLC. The patients with controlled disease may achieve a long survival, and the adverse reactions are mild and tolerable.
出处 《中华肿瘤杂志》 CAS CSCD 北大核心 2009年第2期148-151,共4页 Chinese Journal of Oncology
关键词 非小细胞肺癌 表皮生长因子受体 酪氨酸激酶抑制剂 古非替尼 Non-small cell lung cancer Epidermal growth factor receptor Tyrosine kinase inhibitor Gefitinib
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参考文献11

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二级参考文献35

  • 1吴一龙,杨学宁,杨衿记,黄玉娟.中国的非小细胞肺癌Gefitinib分子靶向治疗[J].中国肺癌杂志,2004,7(4):318-320. 被引量:15
  • 2潘振奎,张力,张星,王欣,李宁,徐菲,常建华,管忠震.中国非小细胞肺癌患者表皮生长因子受体突变的研究[J].癌症,2005,24(8):919-923. 被引量:44
  • 3管忠震,张力,李龙芸,蒋国梁,刘叙仪,储大同,赵洪云,李玮.吉非替尼治疗局部晚期或转移性非小细胞肺癌在中国的临床研究[J].癌症,2005,24(8):980-984. 被引量:114
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  • 9Kris MG, Natale RB, Herbst RS, et al. Efficacy of gefitinib,an inhibitor of the epidermal growth factor receptor tyrosine kinase, in symptomatic patients with non-small cell lung cancer [J]. JAMA, 2003,290(16) :2149-2158.
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