埃克替尼治疗98例复治EGFR突变阳性的晚期肺腺癌的疗效分析  

Efficacy of icotinib in 98 prior-treated patients with EGFR-mutation positive advanced lung adenocarcinoma

作　　者：于晓露[1] 刘俊[1] 王韡旻[1] 潘峰[1] 顾爱琴[1] Yu Xiaolu;Liu Jun;Wang Weimin;Pan Feng;Gu Aiqin(Department of Respiratory Medicine,Chest Hospital Ajfiliated to Shanghai Jiaotong University,Shanghai 200030,China)

机构地区：[1]上海交通大学附属胸科医院呼吸内科,上海200030

出　　处：《现代肿瘤医学》2018年第20期3219-3223,共5页Journal of Modern Oncology

摘　　要：目的:观察埃克替尼治疗复治表皮生长因子受体(epidermal growth factor receptor,EGFR)敏感突变的晚期肺腺癌患者的疗效及不良反应。方法:收集2011年11月至2016年7月期间一线或多线化疗进展的98例EGFR敏感突变的晚期肺腺癌患者应用埃克替尼治疗的疗效、不良反应及生存资料。结果:98例既往化疗失败的EGFR基因敏感突变晚期肺腺癌患者中,达到完全缓解(CR) 1例(1. 0%),部分缓解(PR) 66例(67. 3%),疾病稳定(SD) 20例(20. 4%),疾病进展(PD) 11例(11. 2%);客观缓解率(ORR)为68. 4%(67/98),疾病控制率(DCR)为88. 8%(87/98),中位无进展时间(mPFS)为8. 8个月(95%CI:7. 1～10. 5个月),中位生存时间(mOS)为15. 5个月(95%CI:11. 8～19. 2个月)。亚组分析中,19外显子缺失突变患者的ORR(82. 0%vs 54. 2%,P=0. 003)、mPFS(11. 0个月vs 6. 0个月,P=0. 008)及mOS(20. 0个月vs 12. 6个月,P=0. 016)均优于21外显子L858R突变患者;非脑转移患者的mOS优于脑转移患者(16. 0个月vs 8. 0个月,P=0. 039);不吸烟患者的ORR优于吸烟患者(76. 7%vs 55. 3%,P=0. 023);不同性别、年龄、肺癌分期、治疗线数、转移器官数对预后的影响均未见差异有统计学意义。不良反应以皮疹、腹泻、肝功能异常为主,经对症处理后症状均可明显缓解。结论:埃克替尼治疗既往化疗失败的EGFR突变阳性的晚期肺腺癌患者取得了确切的疗效,且不良反应发生率低。Objective：To evaluate the efficacy and side effects of icotinib in treating prior-treated EGFR-nmta-tion positive advanced lung adenoeareinoma patients. Methods：Collect the efficacy, side effect and survival infforma-tion of 98 advanced EGFR-mutation positive adenoeareinoma patients who progressed after the prior-treatment（s） and started ieotinib therapy between 2011.11-2016.7. Results：Among the 98 EGFR-nmtation positive advanced lung adenoeareinoma patients,complete response（CR） was achieved in 1 patient （ 1.0% ）, partial response （PR） in 66 patients （67.3 % ）, stable disease （ SD ） in 2 0 patients （ 2 0.4 % ） and progressive disease（PD） in 11 patients （ 11.2% ）. The ORR was 68.4% （ 67/98 ） , DCR was 88.8 % （ 87/98 ）. The mPFS was 8.8 months （ 95 % C1：7.1 10.5 months） , mOS was 15.5 months（95% CI ： 11.8 - 19.2 months）. In the subgroup analysis, patients with 19 exonmutation showed better ORR（ 82.0% vs 54.2% ,P = 0.003）, mPFS （ 11.0 months vs 6.0 months, P = 0. 008 ） and mOS （20.0 months vs 12.6 months,P = 0.016） than those with 21 L858R mutation. Patients without brain metastasis showed better mOS than patients with brain metastasis （16.0 months vs 8.0 months,P = 0. 039）. Non-somking patients showed better ORR than smoking patients （76.7 % vs 55.3 %, P = 0. 023 ）. Different gender, ages, clinical stages, total lines of treatments, number of metastasis sites showed similar effect over survival. The main side effects were rash, diarrhea and hepatic injury.These side events were generally alleviated after symptomatic treatment. Conclusion ： Icotinib was effective in treating prior-treated EGFR-mutation positive advanced lung adenocarcinoma patients with low rates of side-events.

关 键 词：埃克替尼 腺癌 复治患者 疗效 EGFR突变阳性 

分 类 号：R734.2[医药卫生—肿瘤]