EGFR-TKI一线治疗不同EGFR突变状态晚期非小细胞肺癌疗效分析  

Association between EGFR mutation status and efficacy of first-line EGFR-TKI in patients with ;advanced non-small cell lung cancer

作　　者：姜海英[1] 李艳芳[1] 朱梅[1] 李倩[1] 吕姣[1] Jiang Haiying Li Yanfang Zhu Mei Li Qian Lyu Jiao(Department of Oncology, Xuzhou Cancer Hospital, Xuzhou 221005, China)

机构地区：[1]徐州市肿瘤医院肿瘤内科,221005

出　　处：《国际肿瘤学杂志》2017年第1期19-23,共5页Journal of International Oncology

摘　　要：目的：分析表皮生长因子受体酪氨酸酶抑制剂（EGFR-TKI）一线治疗不同EGFR突变状态（外显子19缺失、21突变）晚期非小细胞肺癌（NSCLC）的疗效。方法收集徐州市肿瘤医院经组织病理学证实的EGFR突变阳性晚期NSCLC患者72例，分析两种不同EGFR突变状态与一线EGFR-TKI治疗的客观缓解率（ORR）、疾病控制率（DCR）、无进展生存期（PFS）以及总生存期（OS）之间的关系。结果72例患者均进行EGFR基因检测，其中37例为EGFR19外显子缺失，35例为EGFR21外显子突变。72例患者均可评价疗效，其中EGFR19外显子缺失的患者ORR 75．7％，DCR 89．2％；EGFR21外显子突变的患者ORR 51．4％，DCR 68．6％，差异均有统计学意义（χ2＝4．583，P＝0．032；χ2＝4．636，P＝0．031）。EGFR19外显子缺失和21外显子突变的患者校正后的中位PFS分别为13．2个月、10．8个月，差异有统计学意义（χ2＝4．700，P＝0．030）；中位OS分别为30．2个月、25．6个月，差异有统计学意义（χ2＝4．686，P＝0．030）。两组间不良反应无明显差别，皮疹最为常见，两组差异无统计学意义（48．7％∶48．6％，χ2＝0．000，P＝0．995）。结论 EGFR突变状态是晚期NSCLC患者一线EGFR-TKI治疗疗效和OS的预测因素，EGFR19外显子缺失患者的疗效优于EGFR21外显子突变患者。Objective To evaluated the effect of first-line epidermal growth factor receptor tyrosine kinase inhibitor （EGFR-TKI）on advanced non-small cell lung cancer （NSCLC）patients with different EGFR mutation status （exon 1 9 deletion and exon 21 mutation）.Methods Seventy-two advanced NSCLC patients with EGFR mutation confirmed by histopathology were enrolled.All of the patients received first-line EGFR-TKI.The relationships between EGFR mutation status and objective response rate （ORR）,disease control rate （DCR）,progression free survival （PFS ） and overall survival （OS ） were analyzed.Results Of the 72 patients,37 patients expressed exon 1 9 deletion,35 patients expressed exon 21 mutation,and all of them could be evaluated.The ORR and DCR of patients with exon 1 9 deletion were higher than those of patients with exon 21 mutation （75.7%vs.51 .4%,χ2 =4.583,P=0.032;89.2%vs.68.6%,χ2 =4.636,P=0.031 ）.The modified median PFS of patients with exon 1 9 deletion was significantly higher than that of patients with exon 21 mutation （1 3.2 month vs.1 0.8 month,χ2 =4.700,P=0.030）.The median OS of patients with exon 1 9 deletion was significantly higher than that of patients with exon 21 mutation （30.2 month vs.25.6 month,χ2 =4.686,P=0.030）.The side effects were similar between the two groups.The most common adverse reaction was rash,and the incidence had no significant difference between the two groups （48.7% vs.48.6%,χ2 =0.000,P=0.995 ）.Conclusion EGFR mutation status is a predictor for PFS,OS and ORR of first-line EGFR-TKI in patients with advanced NSCLC.NSCLC patients with EGFR exon 1 9 deletion are associated with longer survival time and better response rate compared with those with exon 21 mutation.

关 键 词：受体 表皮生长因子 癌 非小细胞肺 表皮生长因子受体酪氨酸酶抑制剂 

分 类 号：R734.2[医药卫生—肿瘤]