Cetuximab联合一线和非一线化疗方案治疗16例非小细胞肺癌近期疗效及其疗效差异  

Short-term outcomes of 16 patients with non-small cell lung cancer receiving cetuximab combined with standard chemotherapy in the first and non-first line settings

作　　者：丘惠娟[1,2] 夏良平[1,2] 汪芳[1,2] 郭桂芳[1,2] 周菲菲[1,2] 张蓓[1,2] 张力[1,3] 

机构地区：[1]华南肿瘤学国家重点实验室,广东广州510060 [2]中山大学肿瘤防治中心综合科,广东广州510060 [3]中山大学肿瘤防治中心内科,广东广州510060

出　　处：《南方医科大学学报》2010年第11期2423-2426,共4页Journal of Southern Medical University

基　　金：重大新药创新科技重大专项基金(2008ZX09312-002);国家自然科学基金(81071872)~~

摘　　要：目的总结Cetuximab与化疗联合治疗非小细胞肺癌(NSCLC)的经验,以及Cetuximab与一线方案和非一线方案联合时疗效差异。方法收集2006年10月1日到2009年12月31日在中山大学肿瘤防治中心住院并采用Cetuximab联合化疗方案治疗的16例NSCLC患者资料,回顾性分析其近期疗效。结果 (1)共计完成115个Cetuximab治疗周期(总体中位周期数是6,一线方案和非一线方案的中位周期数分别是7.5和2)。(2)一线方案10例,ORR为40.0%(4/10),DCR为80.0%(8/10),中位TTP为6.5月(2～19),中位OS为8.5月(2～48);非一线方案6例,ORR为33.3%(2/6),DCR为33.3%(2/6),中位TTP为3.5月(3～4),中位OS为18月(4～28)。在一线和非一线方案组中ORR、DCR均无显著性差异(P=0.790,P=0.062)。(3)3周内出现皮疹的比例是62.5%(10/16),ORR为60%(6/10),DCR为90%(9/10),3周内未出现皮疹者ORR和DCR均为10.4%(1/6),两者ORR差异无显著性(P=0.080),但DCR有显著性差异(P=0.003)。(4)无因为Cetuximab毒性而停止治疗的,无治疗相关死亡;共计有11例出现皮疹(68.8%),其中10例在3周内出现(62.5%),与化疗相关的副反应有7例。结论初步显示Cetuximab与化疗联合是治疗中国晚期NSCLC患者有效的方案之一,Cetuximab与一线方案联合更有优势。Objective To summarize our experiences with the treatment of non-small cell lung cancer（NSCLC） with cetuximab and compare the therapeutic effects of cetuximab applied in the first line and non-first line settings.Methods From October 1,2006 to December 31,2009,16 NSCLC patients were treated with cetuximab combined with standard chemotherapy in Sun Yat-sen University Cancer Center.The short-term efficacy of the therapeutic protocols were analyzed.Results A total of 115 cycles of cetuximab treatment were administered in these patients with a median of 6 cycles（7.5 in the first line setting and 2 in non-first line setting）.In the 10 patients with cetuximab treatment in the first line setting,the ORR was 40.0%（4/10）,DCR was 80.0%（8/10）,median TTP was 6.5 months（2-19）,and median OS was 8.5 months（2-48）;in the non-first line setting,these indices were 33.3%（2/6）,33.3%（2/6）,3.5 months（3-4） and 18 months（4-28）,respectively.Both ORR and DCR were similar between the first and non-first line settings（P=0.790,P=0.062）.Ten of the patients（62.5%） developed acne-like rash within 3 weeks,who had an ORR of 60%（6/10） and DCR of 90%（9/10）;the ORR and DCR in patients without acne-like rash were both 10.4%（1/6）,showing no significant difference in ORR（P=0.080） but a significant difference in DCR between the two groups（P=0.003）.No treatment-associated death or cetuximab-associated discontinuation occurred.Altogether 11 patients（68.8%） developed acne-like rash,which occurred within 3 weeks in 10 cases.Seven patients showed side effects associated with the chemotherapy.Conclusion Cetuximab combined with standard chemotherapy is a good option for Chinese patients with NSCLC and the current data support the application of cetuximab in the first line setting.

关 键 词：CETUXIMAB 非小细胞肺癌 化学治疗 疗效差异 

分 类 号：R734.2[医药卫生—肿瘤]