奥希替尼治疗62例晚期肺腺癌患者的临床疗效观察  

Clinical efficacy of osimertinib in the treatment of 62 patients with advanced lung adenocarcinoma

作　　者：高志强[1] 王韡旻 蔡雨晴 秦若琰 顾爱琴[1] 熊丽纹[1] 韩宝惠[1] 姜丽岩[1] 施春雷[1] GAO Zhiqiang;WANG Weimin;CAI Yuqing;QIN Ruoyan;GU Aiqin;XIONG Liwen;HAN Baohui;JIANG Liyan;SHI Chunlei(Department of Respiratory Medicine,Shanghai Chest Hospital,Shanghai Jiao Tong University,Shanghai 200030,China;Department of Oncology,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)

机构地区：[1]上海交通大学附属胸科医院/上海市胸科医院呼吸内科,上海200030 [2]上海中医药大学附属龙华医院肿瘤科,上海200032

出　　处：《中国癌症杂志》2019年第10期809-814,共6页China Oncology

摘　　要：背景与目的:表皮生长因子受体-酪氨酸激酶抑制剂(epidermal growth factor receptor-tyrosine kinase inhibitor,EGFR-TKI)在治疗非小细胞肺癌(non-small cell lung cancer,NSCLC)时的原发性或继发性耐药,是在治疗晚期NSCLC时面临的新挑战。奥希替尼是一种第三代EGFR-TKI,其在第一代EGFR-TKI耐药后的NSCLC特别是肺腺癌患者中的疗效和安全性尚不明确。观察奥希替尼治疗晚期肺腺癌患者的疗效及不良反应。方法:2017年4月—2018年9月在上海市胸科医院就诊的诊断明确的晚期(Ⅳ期)肺腺癌患者62例,一线EGFR-TKI治疗后疾病进展,88.7%的患者接受了三线及以上的治疗,观察患者应用奥希替尼治疗的效果及不良反应。结果:62例晚期肺腺癌患者中,部分缓解(partial response,PR)25例(40.3%),疾病稳定(stable disease,SD)28例(45.2%),疾病进展(progressive disease,PD)9例(14.5%)。客观缓解率(objective response rate,ORR)为40.3%(25/62),疾病控制率(disease control rate,DCR)为85.5%(53/62),中位无进展生存期(median progression-free survival,mPFS)为10.30个月(95%CI:9.92~10.68个月)。3度及以上不良反应发生率为11.3%,主要不良反应为腹泻(38.7%)、皮疹(32.2%),经对症处理后可明显缓解。结论:奥希替尼治疗晚期肺腺癌患者取得了确切的疗效,且不良反应发生率低。Background and purpose:Primary or secondary drug resistance to epidermal growth factor receptor(EGFR)tyrosine kinase inhibitors(EGFR-TKI)is a new challenge in the treatment of advanced non-small cell lung cancer(NSCLC).Osimertinib is a third-generation EGFR-TKI,and its efficacy and safety in NSCLC patients with first-generation EGFR-TKI resistance,especially lung adenocarcinoma,are not yet clear.The purpose of this study was to observe the efficacy and adverse reactions of osimertinib in the treatment of patients with advanced lung adenocarcinoma.Methods:From Apr.2017 to Sep.2018,62 patients with advanced(stageⅣ)lung adenocarcinoma were diagnosed in Shanghai Chest Hospital.The diseases were progressed after first-line EGFR-TKI treatment.88.7%of patients received third-line or more treatment.The efficacy and adverse reactions of osimertinib treatment were observed.Results:Among the 62 patients with advanced lung adenocarcinoma,25(40.3%)achieved partial response(PR),28(45.2%)had stable disease(SD),and 9(14.5%)had progressive disease(PD).The objective response rate(ORR)was 40.3%(25/62),the disease control rate(DCR)was 85.5%(53/62),and the median progression-free survival(mPFS)was 10.30 months(95%CI:9.92-10.68 months).The incidence of adverse events of degree 3 and above was 11.3%.The main adverse events were diarrhea(38.7%)and rash(32.2%),which were significantly alleviated after symptomatic treatment.Conclusion:Osimertinib definitely has a curative effect in the treatment of patients with advanced lung adenocarcinoma,and the incidence of adverse reactions is low.

关 键 词：奥希替尼 肺腺癌 疗效 T790M突变 

分 类 号：R734.2[医药卫生—肿瘤]