下一代ALK-TKI类药物在晚期非小细胞肺癌中的疗效研究  

Next-generation ALK-TKI in NSCLC patients

作　　者：颜波 董瑜 张波[1] 张雪艳[1] 储天晴[1] 王姝元 韩宝惠[1] Yan Bo;Dong Yu;Zhang Bo;Zhang Xueyan;Chu Tianqing;Wang Shuyuan;Han Baohui(Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China)

机构地区：[1]上海交通大学附属上海市胸科医院肺内科,200030

出　　处：《中国医师杂志》2018年第12期1814-1816,共3页Journal of Chinese Physician

摘　　要：目的探索下一代间变淋巴瘤激酶-酪氨酸激酶抑制剂(ALK-TKI)药物治疗晚期非小细胞肺癌的疗效及进展方式。方法回顾性分析2014年至2017年就诊于本院的22例病理诊断明确且接受了下一代ALK-TKI治疗的晚期非小细胞肺癌患者的临床资料及结局。结果 22例患者中,男15例,女7例,中位年龄48岁,均为病理确认的晚期腺癌患者,接受ceritinib、alectinib、briga-tinib及lorlatinib治疗的患者分别为12、2、7例及1例;共有14例患者可以进行疗效评估,其中CR 2例,PR 3例,SD 6例,PD 3例,ORR为35. 7%,DCR为78. 6%; 22例患者的中位无进展生存时间(PFS)为8. 7个月;共有17例患者可进行复发方式评估,10例患者因肺部原发进展导致治疗失败,占58. 8%,是导致治疗失败的主要原因; 5例因中枢神经系统进展导致治疗失败,占29. 4%,是导致治疗失败的次要原因。结论下一代ALK-TKI类药物为克唑替尼耐药的患者提供了合理的治疗选择,肺部原发进展是导致下一代ALK-TKI类药物治疗失败的主要原因。通过多学科手段(如放疗)等,增强肺部原发病灶的局部控制率,有可能为延长下一代ALK-TKI类药物的使用时间提供潜在的策略。Objective The aim of the study is to investigate the therapeutic efficacy of next-generation anaplastic lynphoma kinase-tyrosine kinase inhibitor (ALK-TKI) in advanced non-small cell lung cancer (NSCLC). Methods The clinical data and outcomes of 22 patients with advanced non-small cell lung cancer who received the next generation of ALK-TKI from 2014 to 2017 in our hospital were retrospectively analyzed. Results 22 patients were included for survival analysis with 15 males and 7 females. The median age was 48 and all of them were adenocarcinoma patients.There were 12, 2, 7 and 1 patients received ceritinib, alectinib, brigatinib and lorlatinib, respectively. A total of 14 patients could be evaluated, including complete response (CR) in 2 cases, partial response (PR) in 3 cases, stable disease (SD) in 6 cases, progressive disease (PD) in 3 cases. The ORR and DCR were 35.7% and 78.6%, respectively. The median progression free survival (PFS) of the 22 NSCLC patients was 8.7 months. Progression pattern can be analyzed in 17 patients. Among them, 10 patients underwent primary progression (lung), occurring at the leading frequency (accounting for 58.8%) and followed by central nerve system (CNS) progression (accounting for 29.4%). Conclusions Next-generation ALK-TKI provide a reasonable choice for crizotinib-resistant patients. Primary progression (lung) is the leading cause for treatment failure. Multi-disciplinary integration may provide a potential choice for prolonging administration of next-generation ALK-TKI.

关 键 词：癌 非小细胞肺/药物疗法 砜类/治疗应用 卡唑类/治疗应用 有机磷化合物/治疗应用 内酰胺类 大环/治疗应用 

分 类 号：R969[医药卫生—药理学]