埃克替尼联合化疗在有EGFR敏感突变的初治非小细胞肺癌患者中的回顾性分析被引量：8

A retrospective analysis of icotinib combined with chemotherapy in untreated NSCLC with EGFR-sensitive mutations

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摘要目的本研究分析在有表皮生长因子受体(EGFR)突变的初治非小细胞肺癌(NSCLC)患者中埃克替尼与埃克替尼联合化疗或单独化疗的疗效,并分析实际中,不同的基因突变(EGFR外显子19缺失)和L858R突变在不同治疗方法中的疗效。方法在2015年1月-2017年12月的回顾性分析中研究了191例患者。分析了患者的基线特征、疗效及不良事件。主要终点为无进展生存期(PFS)。结果联合治疗组的PFS较长,总生存期(OS)和客观缓解率(ORR)均优于埃克替尼组或化疗组。对于EGFR 19外显子缺失的患者,联合组的PFS、OS和ORR优于埃克替尼或化疗组。对于EGFR L858R突变的患者,联合组PFS和ORR较好,但OS没有明显延长。3级或4级不良事件最常见于联合治疗组或单独化疗组。未发生与药物有关的间质性肺病或与药物有关的死亡。结论埃克替尼与化疗联合应用于有敏感EGFR突变的初治非小细胞肺癌患者,可改善PFS和OS,尤其是那些具有EGFR外显子19缺失的患者。 Objective To investigate and analyze effects of icotinib combined chemotherapy on untreated non small cell lung cancer(NSCLC)patients with epidermal growth factor receptor(EGFR)sensitive gene mutations,and effects of different treatments on different gene mutations(the deletion of EGFR exon 19 and L858R mutation)in practice.Methods A total of 191 patients were studied in the retrospective analysis from January 2015 to December 2017.The baseline characteristics,efficacy and adverse events were analyzed.The main end point was progression free survival(PFS).Results The combination group had longer PFS,a better overall response rate(OS)and a better objective response rate(ORR)than those of either icotinib or chemotherapy.For patients with EGFR exon 19 deletion,PFS,OS and ORR in the combination group were better than those in icotinib or chemotherapy group.For patients with EGFR L858R mutation,PFS and ORR were better in the combined group,but OS was not significantly prolonged.The most common reports of grade 3 or 4 adverse events were in the combination therapy or chemotherapy alone.No drug-related interstitial lung disease or drug-related deaths occurred.Conclusion Icotinib combined with chemotherapy in patients with untreated NSCLC with sensitive EGFR mutations can improve PFS and OS,especially in those with EGFR exon 19 deletion.

作者周欣朱红革范志勤 ZHOU Xin;ZHU Hongge;FAN Zhiqin(The Second Department of Pulmonary Medicine,Xinjiang Medical University,Urumqi 830011,China;Department of Thoracic Surgery,The Third Clinical Medical College,Xinjiang Medical University,Urumqi 830011,China)

机构地区新疆医科大学第三临床医学院肺内科二病区新疆医科大学第三临床医学院胸外科

出处《新疆医科大学学报》 CAS 2019年第2期174-180,共7页 Journal of Xinjiang Medical University

基金新疆维吾尔自治区自然科学基金联合基金(2016D01C366)

关键词非小细胞肺癌埃克替尼化疗一线治疗 EGFR-TKIS non-small cell lung cancer(NSCLC) icotinib chemotherapy first-line treatment epidermal growth factor receptor(EGFR-TKIs)

分类号 R734.2 [医药卫生—肿瘤]