肺腺癌靶向治疗后小细胞肺癌转化的病例报道  

Clinical Observation of Translating to Small Cell Lung Cancer Following Treatment with EGFR-Tyrosine Kinase Inhibitors in Lung Adenocarcinoma

作　　者：薛淑萍[1] 俞婷婷[1] 张琰[1] 单莉[1] 

机构地区：[1]新疆医科大学附属肿瘤医院肺内一科,乌鲁木齐830000

出　　处：《中国肺癌杂志》2015年第10期656-660,共5页Chinese Journal of Lung Cancer

摘　　要：近年来,非小细胞肺癌(non-small cell lung cancer,NSCLC)静脉化疗逐渐进入平台期,缓解率(response rate,RR)、平均总生存期(overall survival,OS)无明显改善;随着分子生物学发展,以表皮生长因子受体(epidermal growth factor receptor,EGFR)为靶点的EGFR酪氨酸激酶抑制剂(EGFR-tyrosine kinase inhibitors,EGFRTKIs)在NSCLC的治疗中疗效显著,但患者最终均会出现耐药,关于耐药机制目前尚未完全明确。本文详细报道1例49岁女性EGFR基因19外显子缺失突变肺腺癌患者,在靶向治疗耐药后二次活检发现转化为小细胞肺癌(small cell lung cancer,SCLC),予以SCLC化疗方案两周期有效;通过分析患者诊疗过程、疗效,对相关机制进展作一综述。In recent years, the chemotherapy of non-small cell lung cancer （NSCLC） has almost been reached a platform stage, and there is no obvious progress in terms of response rate （RR） and overall survival （OS）; With the great devel- opment of molecular biology, epidermal growth factor receptor-tyrosine kinase inhibitors （EGFR-TKIs） has good therapeutic effect on the NSCLC. But, almost all patients of EGFR-mutant lung cancers develop drug resistance to these agents. This paper reported a case of a 49-year-old woman with lung adenocarcinoma who had EGFR mutant （19-DEL） treated with EGFR-TKIs. After disease progression, histological examination of a secondary biopsy specimen revealed small cell lung cancer （SCLC） had transformed to SCLC treatment. Through the analysis of the process and effect of her therapy, the following is a summary of the relevant mechanism.

关 键 词：肺肿瘤 EGFR基因突变 耐药 

分 类 号：R734.2[医药卫生—肿瘤]