晚期肺腺癌患者相关基因状态对培美曲塞疗效影响的研究  

Effect of relative gene status on the efficacy of pemetrexed in the treatment of patients with advanced lung adenocarcinoma

作　　者：于瑞莲[1] 李宏敏[1] 安宁[1] 

机构地区：[1]四川省医学科学院.四川省人民医院肿瘤科,四川成都610072

出　　处：《实用医院临床杂志》2016年第6期36-38,共3页Practical Journal of Clinical Medicine

摘　　要：目的探索有表皮生长因子受体(epidermal growth factor receptor,EGFR)基因突变、间变性淋巴瘤激酶(anaplastic lymphoma kinase,EML4-ALK)融合基因的晚期肺腺癌患者与EGFR基因为野生型、无EML4-ALK融合基因的患者接受培美曲塞加铂类化疗的效果的差异。方法 51例晚期肺腺癌患者根据不同基因状态分为三组:ALK+组13例,EGFR+组18例,野生型组20例,均接受培美曲塞联合顺铂方案化疗,观察总有效率、疾病控制率及无进展生存期。结果 51例晚期肺腺癌患者中,部分缓解率(PR)为41.18%(21/51),疾病控制率(DCR)为80.39%(41/51),中位无进展生存期为6.63月。EML4-ALK+组的疾病控制率较另两组患者明显提高(P<0.05),无进展生存期较另两组患者明显延长(P<0.05)。EGFR突变型组的无进展生存期与野生型组相比差异无统计学意义。结论 EML4-ALK融合基因的患者疾病控制率明显高于EGFR基因突变型及野生型患者,无进展生存时间较EGFR基因突变型及野生型患者明显延长。Objective To explore the curative effect of pemetrexed plus cis-platinum between advanced lung adenocarcinoma patients who had epidermal growth factor receptor （ EGFR） mutations and anaplastic lymphoma kinase （ EML4-ALK） fusion gene and patients who had wild type EGFR but no EML4-ALK fusion gene.Methods Fifty-one patients with advanced lung adenocarcinoma were divided into three groups according to different gene status：ALK＋group （n =13）,EGFR＋group （n =18） and wild type group （n =20）.All the patients were treated with pemetrexed plus cis-platinum.The overall response rate,disease control rate （DCR） and progression free survival （PFS） were observed.Results In the 51 patients,the partial response rate （PR） was 41.18% （21/51）, DCR was 80.39%（41/51）,and the median of PFS was 6.63 months.DCR in the EML4-ALK＋group was significantly higher than that in the other two groups （ P〈0.05） .PFS in the EML4-ALK＋group was significantly longer than that in the other two groups（ P〈0.05）.There was no significant difference in PFS between the EGFR group and the wild type group.Conclusion DCR in the EML4-ALK＋group was significantly higher than that in the other two groups.PFS in the EML4-ALK＋group was longer than that in the EGFR gene mutation and wild type groups.

关 键 词：肺腺癌 表皮生长因子受体 间变性淋巴瘤激酶 

分 类 号：R734.2[医药卫生—肿瘤]