贝伐单抗治疗EGFR野生型或EGFR-TKI耐药的肺腺癌脑转移的疗效和安全性  

Efficacy and safety of bevacizumab combined with chemotherapy in treatment of EGFR wild type or EGFR-TKI resistant lung adenocarcinoma with brain metastases

作　　者：詹琼[1] 周鑫莉[1] 黄若凡[1] 葛蒙晰[1] 季笑宇 梁晓华[1] 

机构地区：[1]复旦大学附属华山医院肿瘤科,上海200040

出　　处：《肿瘤》2016年第10期1139-1145,共7页Tumor

基　　金：国家自然科学基金项目(编号:81302010);上海市科学技术委员会自然科学基金项目(编号:16ZR1404300)~~

摘　　要：目的 :表皮生长因子受体(epidermal growth factor receptor,EGFR)野生型或EGFR酪氨酸激酶抑制剂(EGFR-tyrosine kinase inhibitor,EGFRTKI)耐药的肺腺癌脑转移,目前尚无标准的化疗方案。本研究旨在观察贝伐单抗联合化疗治疗EGFR野生型或EGFR-TKI耐药的肺腺癌脑转移的疗效和安全性。方法 :2015年1月—2015年12月,经病理确诊为肺腺癌的10例肺腺癌脑转移患者接受贝伐单抗联合化疗治疗。化疗2个周期后,按照实体瘤疗效评价标准1.1版评价近期疗效,美国国立癌症研究所通用药物毒性标准3.0版评价不良反应。结果 :10例患者中,8例完成2个周期以上的化疗,可评价疗效。有效率为25%(2/8),疾病控制率为75%(6/8)。颅内病灶有效率为12%(1/8),疾病控制率为87%(7/8)。与贝伐单抗相关的主要不良反应包括高血压、蛋白尿和出血,且大多为Ⅰ和Ⅱ度。结论 :贝伐单抗联合化疗治疗晚期EGFR野生型或EGFR-TKI耐药的肺腺癌脑转移患者显示出较好的疗效,安全性也较好。Objective： There is no standard chemotherapy regimen for patients with wild type epidermal growth factor receptor（EGFR） and EGFRtyrosine kinase inhibitor（TKI） resistant lung adenocarcinoma with brain metastases. This study aims to observe the efficacy and toxicity of chemotherapy combined with bevacizumab in wild-type EGFR and EGFR-TKI resistant lung adenocarcinoma patients with brain metastases.Methods： A total of 10 lung adenocarcinoma patients with brain metastases between January and December 2015 received bevacizumab and chemotherapy. The response was evaluated by Response Evaluation Criteria in Solid Tumors version 1.1（RECIST v1.1） every 2 cycles and the toxicity was evaluated by National Cancer Institute-Common Toxicity Criteria version 3.0（NCI-CTC 3.0） every cycle.Results： Of the eight patients who could be evaluated for response, the overall response rate was 25%（2/8） and the disease control rate was 75%（6/8）. And for intracranial lesions, the response rate was 12%（1/8） and the disease control rate was 87%（7/8）. The most commonly adverse events induced by bevacizumab were hypertension, proteinuria and bleeding, which were mostly degrees Ⅰ-Ⅱ.Conclusion： Bevacizumab combined with chemotherapy is an effective and safe treatment method for EGFR wild type and EGFR-TKI resistant lung adenocarcinoma patients with brain metastases.

关 键 词：癌 非小细胞肺 腺癌 贝伐单抗 脑转移 

分 类 号：R734.2[医药卫生—肿瘤]