中国癌症杂志 ›› 2013, Vol. 23 ›› Issue (6): 462-466.doi: 10.3969/j.issn.1007-3969.2013.06.011

• 论著 • 上一篇    下一篇

EGFR-TKI联合化疗治疗EGFR-TKI获得性耐药的晚期非小细胞肺癌疗效分析

李剑英1,吴晓敏2,何灵慧1,季从飞1,谭清和1   

  1. 1.南通市肿瘤医院肿瘤内科,江苏 南通 226006;
    2.南京医科大学附属南京第一医院肿瘤内科,江苏 南京 210006
  • 出版日期:2013-06-25 发布日期:2014-11-13
  • 通信作者: 谭清和 E-mail:tanqinghe@csco.org.cn

Efficacy of EGFR-TKI and chemotherapy in advanced non-small cell lung cancer with EGFR-TKI resistence

LI Jian-ying1, WU Xiao-min2, HE Ling-hui1, JI Cong-fei1, TAN Qing-he1   

  1. 1.Department of Oncology, Nantong Cancer Hospital, Nantong Jiangsu 226006, China; 2.Department of Oncology, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing Jiangsu 210006, China
  • Published:2013-06-25 Online:2014-11-13
  • Contact: TAN Qing-he E-mail: tanqinghe@csco.org.cn

摘要:

背景与目的:对于(epidermal growth factor receptor tyrosine kinase inhibitorEGFRTKI)治疗失败的非小细胞肺癌(non-small cell lung cancerNSCLC)患者亟需探索新的治疗策略来延缓或克服EGFR-TKI的获得性耐药。本研究旨在比较对此类患者采用化疗联合EGFR-TKI与单化疗的疗效及不良反应。方法:符合入组标准的18例患者中,8例接受化疗联合EGFR-TKI(CE)10例接受单化疗(C)21 d1个周期,至少完成2个周期化疗的患者进行疗效及不良反应评价。结果:18例患者均可评价疗效,其中CE组客观反应率(objective response rateORR)25%CORR10%,两组比较差异无统计学意义(P=0.832)CE组疾病控制率(disease control rateDCR)87.5%,中位无进展生存期(progression free survivalPFS)3.5个月,CDCR30%,中位PFS2.4个月,两组比较差异有统计学意义(P=0.046P=0.05)CE组皮疹发生率高于C(75vs 10),两组Ⅲ、Ⅳ度不良反应的差异均无统计学意义(P>0.05)结论:EGFR突变阳性的NSCLC患者,在EGFR-TKI耐药后继续使用EGFR-TKI并联用化疗可延缓疾病进展,是EGFR-TKI治疗失败的NSCLC患者的一项治疗策略。

关键词: 非小细胞肺癌, 表皮生长因子酪氨酸激酶抑制剂耐药, 化疗

Abstract:

Background and purpose: New treatment strategies should be explored for non-small cell lung cancer (NSCLC) patients after the failure of the epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI). To compare the efficacy and toxicities of chemotherapy in combination with EGFR-TKI or single chemotherapy in advanced NSCLC patients with EGFR-TKI resistence. Methods: In this study, 18 patients were enrolled. Eight patients were treated by chemotherapy combined with EGFR-TKI (CE group); 10 patients were treated by single chemotherapy (E group), 21 days for one cycle. All patients received at least 2 cycles of treatment. Results: All 18 patients had been evaluated. The CE group was similar to the E group in objective response rate (ORR: 25% vs 10%, P=0.832). The CE group was higher than the E group in disease control rate (DCR: 87.5% vs 30%, P=0.046). The median PFS was longer in CE group (3.5 months vs 2.4 months, P=0.05). The CE group was higher than the E group in rash (75% vs 10%, P<0.05). The grade 3-4 toxicities did not have significantly differences between the two groups (P>0.05). Conclusion: Though there was no significant difference in ORR between the 2 groups (P>0.05), the CE group was superior to the E group in DCR and PFS. Patients with retreatment of advanced NSCLC after the failure of EGFR-TKI can be controlled by continued EGFR-TKI and chemotherapy.

Key words: Non-small cell lung cancer, EGFR-TKI resistence, Chemotherapy