埃克替尼一线治疗134例EGFR突变阳性的晚期肺腺癌的疗效分析  

Efficacy of Icotinib as First-Line Therapy for 134 Patients with Advanced Lung Adenocarcinoma of Positive EGFR Mutation

作　　者：于晓露[1] 王慧敏[1] 王韡旻[1] 施春雷[1] 韩宝惠[1] 姜丽岩[1] 潘峰[1] 顾爱琴[1] 

机构地区：[1]上海交通大学附属胸科医院,上海200030

出　　处：《肿瘤学杂志》2017年第9期772-775,共4页Journal of Chinese Oncology

摘　　要：[目的]观察埃克替尼一线治疗EGFR突变阳性的晚期肺腺癌患者的疗效及不良反应。[方法]对134例Ⅲb/Ⅳ期EGFR突变阳性的晚期肺腺癌患者应用埃克替尼125mg每天三次治疗,直至疾病进展或出现不可耐受的不良反应。[结果]134例EGFR基因突变阳性晚期肺腺癌患者中,完全缓解(CR)6例(4.5%),部分缓解(PR)90例(67.2%),疾病稳定(SD)32例(23.9%),疾病进展(PD)6例(4.5%)。客观缓解率(ORR)为71.6%(96/134),疾病控制率(DCR)为95.5%(128/134)。中位无进展时间(mPFS)为11.2个月(95%CI:9.8~12.5个月),OS尚未获得。19外显子缺失突变的ORR为81.8%,DCR为93.5%,m PFS为11.8个月。21外显子L858R突变患者ORR为57.9%,DCR为94.7%,m PFS为10.2个月。19外显子缺失突变的ORR明显优于21外显子L858R突变(81.8%vs 57.9%,P=0.002)。不吸烟患者的ORR优于吸烟患者(77.4%vs 58.5%,P=0.025)。不同性别、年龄、肺癌分期、EGFR突变类型、吸烟状态对m PFS和DCR的影响无统计学差异。主要不良反应为Ⅰ~Ⅱ度的皮疹(44.8%)和腹泻(25.3%),经对症处理后,患者多可耐受。[结论]埃克替尼一线治疗EGFR突变阳性的晚期肺腺癌患者取得了很好的疗效,不良反应的发生率低,且患者多可耐受。[Objective] To investigate the efficacy and adverse effect of icotinib as first-line therapy in treatment of patients with EGFR-mutation positive advanced lung adenocarcinoma. [Methods]One hundred and thirty four patients with EGFR-mutation positive advanced lung adenocarcinoma received oral icotinib（125mg,tid） as first-line therapy until disease progression or intolerable toxicity appeared. [Results] Among 134 patients,complete response（CR） was achieved in 6 cases（4.5%）,partial response（PR） in 90 cases（67.2%）,stable disease（SD） in 32 cases（23.9%） and progressive disease（PD） in 6 cases（4.5%）. The ORR was 71.6%（96/134）,DCR was 95.5%（128/134）,m PFS was 11.2 months（95%CI：9.8~12.5months）,and OS was not obtained yet. The ORR,DCR and m PFS of 19 exon muntation positive patients were 81.8%,93.5%,11.8months,respectively. The ORR,DCR and m PFS of 21 exon muntation positive patients were 57.9%,94.7%,10.2months,respectively. Patients with 19 exon mutation showed better ORR than those with 21 L858 R mutation（81.8% vs 57.9%,P=0.002）. Non-smoking patients showed better ORR than smokers（77.4% vs58.5%,P=0.025）. There were no significant differences in mPFS and DCR among patients of different gender,age,clinical stage,EGFR mutation state and smoking state. The main adverse effects wereⅠ~Ⅱ degrees of rash（44.8%） and diarrhea（25.3%）,which were generally tolerated after symptomatic treatment. [Conclusion] The results suggest that icotinib is effective for patients with EGFR-mutation positive advanced lung adenocarcinoma as first-line therapy with low and tolerated adverse effects.

关 键 词：埃克替尼 腺癌 一线治疗 疗效 

分 类 号：R734.2[医药卫生—肿瘤]