甲磺酸阿帕替尼联合埃克替尼治疗埃克替尼耐药的非小细胞肺癌的效果分析  

Analysis of the efficacy of apatinib mesylate combined with icotinib in the treatment of icotinib-resistant non-small cell lung cancer

作　　者：张明晖[1] 孙雅丽[1] 杨艳[1] 赵妍[1] 魏海波 牛意 ZHANG Minghui;SUN Yali;YANG Yan;ZHAO Yan;WEI Haibo;NIU Yi(Department of Oncology,Chifeng Municipal Hospital,Chifeng 024000,Inner Mongolia,China)

机构地区：[1]赤峰市医院肿瘤内科,内蒙古赤峰0240000

出　　处：《癌症进展》2019年第7期798-800,807,共4页Oncology Progress

摘　　要：目的分析甲磺酸阿帕替尼联合埃克替尼治疗埃克替尼耐药的非小细胞肺癌(NSCLC)的效果。方法选取17例埃克替尼耐药的NSCLC患者,均给予甲磺酸阿帕替尼联合埃克替尼治疗,分析临床疗效、不良反应的发生情况以及治疗前后血清血管内皮生长因子(VEGF)水平、基质金属蛋白酶9(MMP9)水平、癌胚抗原(CEA)水平、卡氏体力状况(KPS)评分及生活质量的变化情况。结果治疗后,完全缓解(CR)0例,部分缓解(PR)7例,疾病稳定(SD)5例,疾病进展(PD)5例;客观有效率(ORR)为41.18%,疾病控制率(DCR)为70.59%;随访至2017年10月,患者的中位无进展生存时间(PFS)为6.8个月;治疗后出现蛋白尿1例,白细胞减少1例,手足综合征2例,不良反应的总发生率为23.53%;治疗后,患者的血清MMP9、VEGF、CEA水平均明显低于治疗前,差异均有统计学意义(P﹤0.01);治疗后,患者的KPS评分、生活质量评分均明显高于治疗前,差异均有统计学意义(P﹤0.01)。结论甲磺酸阿帕替尼联合埃克替尼治疗埃克替尼耐药的NSCLC,疗效较好且不良反应发生率较低,可提高患者的生活质量,值得进一步推广。Objective To investigate the efficacy of apatinib mesylate combined with icotinib in the treatment of icotinib- resistant non- small cell lung cancer (NSCLC).Method The research enrolled 17 cases of icotinib- resistant NSCLC,who were administered with apatinib mesylate combined with icotinib.The clinical efficacy,occurrence of adverse reactions,serum vascular endothelial growth factor (VEGF),matrix metalloproteinase 9 (MMP9),carcinoembryonic antigen (CEA),Karnofsky performance status (KPS) scale and quality of life before and after treatment were evaluated. Result After treatment,there was no patient achieving complete response (CR),while 7 had partial response (PR),additionally, stable disease (SD) was observedin 5 cases,and progressive disease (PD) in 5 cases;the objective response rate (ORR) was 41.18%,and disease control rate (DCR) was 70.59%;patients were followed up till October 2017,and the median progression free survival (PFS) was 6.8 months;after treatment,there was 1 case of proteinuria,1 case of leukopenia, 2 cases of hand- foot syndrome,thus the overall incidence of adverse reactions was 23.53%;the level of serum MMP9,VEGF and CEA in these patients were significantly decreased compared with those before treatment (P<0.01);additionally,the KPS score and the score of quality of life were improved markedly after treatment (P<0.01).Conclusion In the treatment of icotinib-resistant NSCLC,apatinib mesylate combined with icotinib exhibits fairly good clinical efficacy, with acceptable adverse reactions,and the regimen may effectively improve the quality of life of patients.

关 键 词：甲磺酸阿帕替尼 埃克替尼 耐药 非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤]