李剑英, 吴晓敏, 何灵慧, et al. Efficacy of EGFR-TKI and chemotherapy in advanced non-small cell lung cancer with EGFR-TKI resistence[J]. China Oncology, 2013, 23(6): 462-466.
李剑英, 吴晓敏, 何灵慧, et al. Efficacy of EGFR-TKI and chemotherapy in advanced non-small cell lung cancer with EGFR-TKI resistence[J]. China Oncology, 2013, 23(6): 462-466. DOI: 10.3969/j.issn.1007-3969.2013.06.011.
背景与目的:对于(epidermal growth factor receptor tyrosine kinase inhibitor,EGFRTKI)治疗失败的非小细胞肺癌(non-small cell lung cancer,NSCLC)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组),10例接受单化疗(C组),21 d为1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 rate,ORR)为25%,C组ORR为10%,两组比较差异无统计学意义(P=0.832);CE组疾病控制率(disease control rate,DCR)为87.5%,中位无进展生存期(progression free survival,PFS)为3.5个月,C组DCR为30%,中位PFS为2.4个月,两组比较差异有统计学意义(P=0.046,P=0.05)。CE组皮疹发生率高于C组(75% vs 10%),两组Ⅲ、Ⅳ度不良反应的差异均无统计学意义(P0.05)。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。
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%
P0.05). The grade 3-4 toxicities did not have significantly differences between the two groups (P0.05). Conclusion: Though there was no significant difference in ORR between the 2 groups (P0.05)
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.