液体活检指导下的非小细胞肺癌精准治疗  

The Precision Therapy of Non-small Cell Lung Cancer Under the Guidance of Liquid Biopsy

作　　者：李均勇[1,2] 王椿[3] 周晓娟[4] 丁振宇[4] 

机构地区：[1]四川大学,成都610065 [2]成都市龙泉驿区第一人民医院肿瘤科,成都610100 [3]四川大学华西医院内分泌与代谢科,成都610041 [4]四川大学华西医院胸部肿瘤科,成都610041

出　　处：《成都医学院学报》2017年第1期49-53,共5页Journal of Chengdu Medical College

基　　金：国家自然科学基金(No:82172684)

摘　　要：目的探讨液体活检用于非小细胞肺癌(non-small cell lung cancer,NSCLC)精准治疗的潜在价值。方法本研究采用回顾性分析,纳入2015年3月到2016年3月四川大学华西医院胸部肿瘤科及肺癌中心液体活检指导下,行精准治疗的晚期NSCLC患者共11例。液体活检方法采用扩增阻滞突变系统方法,或数字PCR方法,或下一代测序方法。靶向治疗药物包括吉非替尼、埃克替尼及奥西替尼。结果 11例患者分别口服吉非替尼(7例,63.6%)、埃克替尼(2例,18.2%)和奥西替尼(2例,18.2%)。7例患者最佳疗效达到部分缓解(partial response,PR)(63.6%),3例最佳疗效为稳定(stable disease,SD)(27.3%),有1例患者口服奥西替尼很快出现进展(progression disease,PD)(9.1%)。全组病人中位无进展时间(progression free survival,PFS)为8.0月(95%CI:2.3~13.7月),中位总生存时间(overall survival,OS)仍未达到。有3例肿瘤组织与液体活检结果不符的患者,疗效分别为PR(2例)及PD(1例)。结论液体活检用于指导NSCLC的精准治疗值得进一步研究。Objective To explore the potential value of liquid biopsy in the precision therapy for the non-small cell lung cancer （NSCLC）.Methods The retrospective method was adopted to analyze the data of 11 cases with advanced NSCLC treated with the precision therapy under the guidance of liquid biopsy from March of 2015 to March of 2016 in West China Hospital of Sichuan University.The liquid biopsy was performed by the methods including the amplification refractory mutation system,digital polymerase chain reaction （PCR）and next generation sequencing.The targeted drugs involved Gefitinib,Icotinib and Osimertinib.Results Among the 11 cases,7 patients （63.6%）were given Gefitinib,2 patients （18.2%）were given Icotinib and the other two patients were given Osimertinib.After the treatment,7 cases （63.6）achieved the partial response （PR）,3 cases （27.3%）had the stable disease （SD）,and the only one case （9.1%）taking Osimertinib had propression disease （PD）.The median progression free survival （PFS）was 8.0 months （95%CI：2.3-13.7 months）and the median overall survival was not reached.3 patients had discordant results in the tests of tumors and liquid biopsy and they were 2 cases with PR and 1 case with PD respectively.Conclusion More further research is worth doing in the precision therapy for NSCLC under the guidance of liquid biopsy.

关 键 词：非小细胞肺癌 液体活检 精准治疗 

分 类 号：R246.5[医药卫生—针灸推拿学]